Provider Demographics
NPI:1558639880
Name:LONE STAR INTEROPERATIVE SPINAL MONITORING, LLC
Entity Type:Organization
Organization Name:LONE STAR INTEROPERATIVE SPINAL MONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPSIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-675-0905
Mailing Address - Street 1:8409 PICKWICK LN # 175
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5323
Mailing Address - Country:US
Mailing Address - Phone:214-675-0905
Mailing Address - Fax:214-317-4888
Practice Address - Street 1:8409 PICKWICK LN # 175
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5323
Practice Address - Country:US
Practice Address - Phone:214-675-0905
Practice Address - Fax:214-317-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty