Provider Demographics
NPI:1700016664
Name:LONE STAR PM & R GROUP
Entity Type:Organization
Organization Name:LONE STAR PM & R GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:MULROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-222-2606
Mailing Address - Street 1:414 NAVARRO ST
Mailing Address - Street 2:#816
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2815
Mailing Address - Country:US
Mailing Address - Phone:210-222-2606
Mailing Address - Fax:210-222-8410
Practice Address - Street 1:414 NAVARRO ST
Practice Address - Street 2:#816
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2516
Practice Address - Country:US
Practice Address - Phone:210-222-2606
Practice Address - Fax:210-222-8410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127473005Medicaid
TX127473005Medicaid