Provider Demographics
NPI:1639225550
Name:LONE STAR CIRCLE OF CARE
Entity Type:Organization
Organization Name:LONE STAR CIRCLE OF CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FERMINA
Authorized Official - Middle Name:AMARILIS
Authorized Official - Last Name:ESPAILLAT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:512-828-3300
Mailing Address - Street 1:3102 MINTHORN DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-1932
Mailing Address - Country:US
Mailing Address - Phone:254-268-1385
Mailing Address - Fax:
Practice Address - Street 1:3102 MINTHORN DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-1932
Practice Address - Country:US
Practice Address - Phone:254-268-1385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628558171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty