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NPI Code Detail

MEDICARE: LONE STAR NEONATOLOGY AT NORTH TEXAS, PLLC

MEDICARE: LONE STAR NEONATOLOGY AT NORTH TEXAS, PLLC
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
12080P0203XPediatric Critical Care Medicine Physician

General Provider Information

NPI Number : 1740088723
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONE STAR NEONATOLOGY AT NORTH TEXAS, PLLC
Provider Business Mailing Address
First Line : 2000 HEALTH PARK DR
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4692
Country : US
Telephone Number : 615-373-7406
Fax Number :
Provider Business Practice Location Address
First Line : 3101 N TARRANT PKWY
Second Line :
City : FT WORTH
State : TX
Zip : 76177-8656
Country : US
Telephone Number : 817-639-1000
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : CARLOS MOAS
Credential :
Telephone Number : 786-494-5154
Provider Enumeration Date : 03/05/2025
Last Update Date : 11/11/2025

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