Provider Demographics
NPI:1215543459
Name:LONESTAR PHYSICIANS PLLC
Entity Type:Organization
Organization Name:LONESTAR PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KHURRAM
Authorized Official - Middle Name:I
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-432-9856
Mailing Address - Street 1:22 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-9204
Mailing Address - Country:US
Mailing Address - Phone:281-432-9856
Mailing Address - Fax:
Practice Address - Street 1:1610 W BAKER RD STE A
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2279
Practice Address - Country:US
Practice Address - Phone:281-432-9856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty