Provider Demographics
NPI:1326023318
Name:LONE STAR DME INC
Entity Type:Organization
Organization Name:LONE STAR DME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:EKPENYONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-388-0200
Mailing Address - Street 1:3727 DILIDO RD
Mailing Address - Street 2:#136
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-5531
Mailing Address - Country:US
Mailing Address - Phone:214-388-0200
Mailing Address - Fax:214-388-0215
Practice Address - Street 1:3727 DILIDO RD
Practice Address - Street 2:#136
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-5531
Practice Address - Country:US
Practice Address - Phone:214-388-0200
Practice Address - Fax:214-388-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0053787A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4185780001Medicare ID - Type Unspecified