Provider Demographics
NPI:1508232299
Name:LONESTAR SPINE SPECIALISTS PLLC
Entity Type:Organization
Organization Name:LONESTAR SPINE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:SEAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-378-4656
Mailing Address - Street 1:PO BOX 674074
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4074
Mailing Address - Country:US
Mailing Address - Phone:214-378-4656
Mailing Address - Fax:866-375-8173
Practice Address - Street 1:9303 PINECROFT DR
Practice Address - Street 2:SUITE 320
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3181
Practice Address - Country:US
Practice Address - Phone:214-378-4656
Practice Address - Fax:866-375-8173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty