Provider Demographics
NPI:1568748580
Name:LONESTAR THERAPY, LLC
Entity Type:Organization
Organization Name:LONESTAR THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW-TEMP
Authorized Official - Phone:956-351-5289
Mailing Address - Street 1:PO BOX 1158
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-1158
Mailing Address - Country:US
Mailing Address - Phone:956-351-5289
Mailing Address - Fax:956-351-5294
Practice Address - Street 1:1400 N WESTGATE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-3996
Practice Address - Country:US
Practice Address - Phone:956-351-5289
Practice Address - Fax:956-351-5294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty