MEDICARE: LONE STAR DME INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	0053787A	TX

General Provider Information

NPI Number	:	1326023318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONE STAR DME INC

Provider Business Mailing Address
First Line	:	3727 DILIDO RD
Second Line	:	#136
City	:	DALLAS
State	:	TX
Zip	:	75228-5531
Country	:	US
Telephone Number	:	214-388-0200
Fax Number	:	214-388-0215

Provider Business Practice Location Address
First Line	:	3727 DILIDO RD
Second Line	:	#136
City	:	DALLAS
State	:	TX
Zip	:	75228-5531
Country	:	US
Telephone Number	:	214-388-0200
Fax Number	:	214-388-0215

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. SAMUEL O EKPENYONG
Credential	:
Telephone Number	:	214-388-0200

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	08/22/2020

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Directions to “LONE STAR DME INC ” Practice Location

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