Provider Demographics
NPI:1184246985
Name:LONE STAR SPINE AND INJURY CENTER, PLLC
Entity type:Organization
Organization Name:LONE STAR SPINE AND INJURY CENTER, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UMAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-360-3264
Mailing Address - Street 1:2700 CITIZENS PLZ STE 207
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5755
Mailing Address - Country:US
Mailing Address - Phone:361-360-3264
Mailing Address - Fax:833-471-5910
Practice Address - Street 1:2700 CITIZENS PLZ STE 207
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5755
Practice Address - Country:US
Practice Address - Phone:361-360-3264
Practice Address - Fax:833-471-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty