Provider Demographics
NPI:1134257587
Name:LONE STAR LAP-BAND, P.A.
Entity type:Organization
Organization Name:LONE STAR LAP-BAND, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-772-4333
Mailing Address - Street 1:PO BOX 2512
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-9012
Mailing Address - Country:US
Mailing Address - Phone:972-772-4333
Mailing Address - Fax:972-772-4005
Practice Address - Street 1:8301 LAKEVIEW PKWY
Practice Address - Street 2:STE. 210
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-9320
Practice Address - Country:US
Practice Address - Phone:972-412-6500
Practice Address - Fax:972-412-6415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty