Provider Demographics
NPI:1790420743
Name:LONE STAR VISION GROUP, PLLC
Entity Type:Organization
Organization Name:LONE STAR VISION GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEJOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:254-615-1082
Mailing Address - Street 1:1455 E WHITESTONE BLVD STE G145
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7722
Mailing Address - Country:US
Mailing Address - Phone:254-615-1082
Mailing Address - Fax:254-615-1097
Practice Address - Street 1:1455 E WHITESTONE BLVD STE G145
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7722
Practice Address - Country:US
Practice Address - Phone:254-615-1082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty