MEDICARE: LONE STAR CIRCLE OF CARE

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	261QF0400X	Federally Qualified Health Center (FQHC)	261QF0400X	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447316898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONE STAR CIRCLE OF CARE

Provider Business Mailing Address
First Line	:	2423 WILLIAMS DR STE 107
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-3269
Country	:	US
Telephone Number	:	877-800-5722
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 ROUND ROCK AVE STE 208
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4026
Country	:	US
Telephone Number	:	877-800-5722
Fax Number	:	512-255-5307

Authorized Official
Title or Position	:	CEO
Name	:	JONATHAN DAVID CALVIN
Credential	:
Telephone Number	:	512-994-1933

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	05/12/2025

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Directions to “LONE STAR CIRCLE OF CARE ” Practice Location

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