Provider Demographics
NPI:1609958982
Name:LONE STAR SCOOTERS, L.L.C.
Entity Type:Organization
Organization Name:LONE STAR SCOOTERS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-346-0000
Mailing Address - Street 1:6225 OAKMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-2812
Mailing Address - Country:US
Mailing Address - Phone:817-346-0000
Mailing Address - Fax:817-346-1150
Practice Address - Street 1:6225 OAKMONT BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-2812
Practice Address - Country:US
Practice Address - Phone:817-346-0000
Practice Address - Fax:817-346-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0072472332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX531777OtherBCBS
TX1563645Medicaid
452210OtherJACHO
TXV16951OtherVGM
452210OtherJACHO