Provider Demographics
NPI:1609414937
Name:LONESTAR VISITING PHYSICIANS LLC
Entity Type:Organization
Organization Name:LONESTAR VISITING PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-394-5991
Mailing Address - Street 1:406 HALLIDAY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-4057
Mailing Address - Country:US
Mailing Address - Phone:210-394-5991
Mailing Address - Fax:
Practice Address - Street 1:4115 MEDICAL DR STE 301
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5622
Practice Address - Country:US
Practice Address - Phone:210-394-5991
Practice Address - Fax:210-890-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty