Provider Demographics
NPI:1982989463
Name:LONESTAR PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:LONESTAR PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:YUEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-206-0808
Mailing Address - Street 1:1016 LA POSADA DR STE 285
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TEXAS
Mailing Address - Zip Code:78752
Mailing Address - Country:UM
Mailing Address - Phone:512-206-0808
Mailing Address - Fax:512-206-0844
Practice Address - Street 1:1016 LA POSADA DR STE 285
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3817
Practice Address - Country:US
Practice Address - Phone:512-206-0808
Practice Address - Fax:512-206-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287115401Medicaid
TX287115401Medicaid