Provider Demographics
NPI:1093995714
Name:LONE STAR UROLOGY PLLC
Entity Type:Organization
Organization Name:LONE STAR UROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-476-9850
Mailing Address - Street 1:2911 MEDICAL ARTS ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3376
Mailing Address - Country:US
Mailing Address - Phone:512-476-9850
Mailing Address - Fax:512-236-8867
Practice Address - Street 1:2911 MEDICAL ARTS ST STE 1A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3376
Practice Address - Country:US
Practice Address - Phone:512-476-9850
Practice Address - Fax:512-236-8867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0598174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157730601OtherMEDICAID GROUP
TX8845B6OtherMEDICARE INDIV
TX8Z1915OtherBCBS INDIV
TX1578672739OtherNPI INDIVIDUAL
TX3469HMOtherBCBS GROUP
TX1093995714OtherNPI GROUP
TX113480104Medicaid
TX1093995714OtherNPI GROUP
TX1578672739OtherNPI INDIVIDUAL