Provider Demographics
NPI:1740803907
Name:LONESTAR MEDITEX
Entity Type:Organization
Organization Name:LONESTAR MEDITEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-831-5429
Mailing Address - Street 1:11104 W AIRPORT BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3035
Mailing Address - Country:US
Mailing Address - Phone:832-243-1398
Mailing Address - Fax:
Practice Address - Street 1:11104 W AIRPORT BLVD STE 211
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3035
Practice Address - Country:US
Practice Address - Phone:832-243-1398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies