Provider Demographics
NPI:1841566155
Name:LONE STAR SURGEONS GROUP, PLLC
Entity Type:Organization
Organization Name:LONE STAR SURGEONS GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:COONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-219-8265
Mailing Address - Street 1:925 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3955
Mailing Address - Country:US
Mailing Address - Phone:575-523-6330
Mailing Address - Fax:575-523-6331
Practice Address - Street 1:7812 GATEWAY BLVD E
Practice Address - Street 2:230
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1803
Practice Address - Country:US
Practice Address - Phone:915-219-8265
Practice Address - Fax:915-219-9508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9223208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty