Provider Demographics
NPI:1215543566
Name:ORTHOLONESTAR, PLLC
Entity Type:Organization
Organization Name:ORTHOLONESTAR, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-439-1000
Mailing Address - Street 1:9301 NORTH CENTRAL EXPY
Mailing Address - Street 2:TOWER 1, STE 500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-220-2468
Mailing Address - Fax:
Practice Address - Street 1:9301 NORTH CENTRAL EXPY
Practice Address - Street 2:TOWER 1, STE 500
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7523
Practice Address - Country:US
Practice Address - Phone:214-220-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOLONESTAR PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-22
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty