MEDICARE: LONE STAR EMERGENCY ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1215266606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONE STAR EMERGENCY ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	1000 RIVER RD
Second Line	:	SUITE 100
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2439
Country	:	US
Telephone Number	:	800-355-0808
Fax Number	:	610-834-2862

Provider Business Practice Location Address
First Line	:	3201 HIGHWAY 71 E
Second Line	:
City	:	BASTROP
State	:	TX
Zip	:	78602-5126
Country	:	US
Telephone Number	:	512-321-8200
Fax Number	:	512-321-8701

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES R. BRAND
Credential	:	M.D.
Telephone Number	:	800-355-0808

Provider Enumeration Date	:	12/14/2009
Last Update Date	:	12/14/2009

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