Provider Demographics
NPI:1558556845
Name:LONESTAR MEDICAL SUPPLY
Entity type:Organization
Organization Name:LONESTAR MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNE/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOL
Authorized Official - Middle Name:
Authorized Official - Last Name:OPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-279-1795
Mailing Address - Street 1:9898 BISSONNET ST
Mailing Address - Street 2:SUITE 584
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8270
Mailing Address - Country:US
Mailing Address - Phone:832-279-1795
Mailing Address - Fax:
Practice Address - Street 1:9898 BISSONNET ST
Practice Address - Street 2:SUITE 584
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8270
Practice Address - Country:US
Practice Address - Phone:832-279-1795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059101332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies