Provider Demographics
NPI:1831641059
Name:LONE STAR CARDIOVASCULAR CENTER PLLC
Entity Type:Organization
Organization Name:LONE STAR CARDIOVASCULAR CENTER PLLC
Other - Org Name:ENDOVASCULAR INNOVATIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:NEELAGARU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-779-6122
Mailing Address - Street 1:1840 NE LOOP 410
Mailing Address - Street 2:STE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217
Mailing Address - Country:US
Mailing Address - Phone:210-817-4848
Mailing Address - Fax:
Practice Address - Street 1:1840 NE LOOP 410
Practice Address - Street 2:STE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-1070
Practice Address - Country:US
Practice Address - Phone:210-817-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty