MEDICARE: LONE STAR DAY PROGRAM

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	261QD1600X	Developmental Disabilities Clinic/Center
3	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1801210505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONE STAR DAY PROGRAM

Provider Business Mailing Address
First Line	:	PO BOX 1168
Second Line	:
City	:	LINDALE
State	:	TX
Zip	:	75771-1168
Country	:	US
Telephone Number	:	903-520-6243
Fax Number	:	903-496-0298

Provider Business Practice Location Address
First Line	:	14623 FM 849
Second Line	:
City	:	LINDALE
State	:	TX
Zip	:	75771-2440
Country	:	US
Telephone Number	:	903-520-6243
Fax Number	:	903-496-0298

Authorized Official
Title or Position	:	OWNER
Name	:	KIM BUTLER
Credential	:	RN
Telephone Number	:	903-520-6243

Provider Enumeration Date	:	02/17/2014
Last Update Date	:	09/23/2025

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Directions to “LONE STAR DAY PROGRAM ” Practice Location

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