Provider Demographics
NPI:1902402183
Name:LONE STAR ENDOSCOPY OF AUSTIN, PLLC
Entity Type:Organization
Organization Name:LONE STAR ENDOSCOPY OF AUSTIN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAHESH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-963-1428
Mailing Address - Street 1:9312 BRODIE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5176
Mailing Address - Country:US
Mailing Address - Phone:512-963-1428
Mailing Address - Fax:
Practice Address - Street 1:9312 BRODIE LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5176
Practice Address - Country:US
Practice Address - Phone:512-963-1428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical