Provider Demographics
NPI:1134141625
Name:LONE STAR EYE CARE, PA
Entity type:Organization
Organization Name:LONE STAR EYE CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCMENEMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-277-8400
Mailing Address - Street 1:3515 TOWN CENTER BLVD S
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1285
Mailing Address - Country:US
Mailing Address - Phone:281-277-8400
Mailing Address - Fax:281-277-8408
Practice Address - Street 1:3515 TOWN CENTER BLVD S
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1285
Practice Address - Country:US
Practice Address - Phone:281-277-8400
Practice Address - Fax:281-277-8408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184978801Medicaid
TXC19208Medicare UPIN
TX136886202Medicaid