Provider Demographics
NPI:1710982780
Name:LUNGSTAR PULMONARY DIAGNOSTIC SERVICES, INC.
Entity Type:Organization
Organization Name:LUNGSTAR PULMONARY DIAGNOSTIC SERVICES, INC.
Other - Org Name:LUNGSTAR DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:T
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:972-422-4800
Mailing Address - Street 1:1612 J. AVENUE
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6117
Mailing Address - Country:US
Mailing Address - Phone:972-422-4800
Mailing Address - Fax:972-422-4333
Practice Address - Street 1:1612 J. AVENUE
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6117
Practice Address - Country:US
Practice Address - Phone:972-422-4800
Practice Address - Fax:972-422-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic