Lone Star Circle Of Care At Bastrop | |
605 Old Austin Hwy Bastrop TX 78602-5034 | |
(877) 800-5722 | |
Not Available |
Full Name | Lone Star Circle Of Care At Bastrop |
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Speciality | Clinic/Center |
Location | 605 Old Austin Hwy, Bastrop, Texas |
Authorized Official Name and Position | Jonathan David Calvin (CEO) |
Authorized Official Contact | 5129941933 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lone Star Circle Of Care At Bastrop 205 E University Ave Suite 200 Georgetown TX 78626-6814 Ph: (512) 686-0207 | Lone Star Circle Of Care At Bastrop 605 Old Austin Hwy Bastrop TX 78602-5034 Ph: (877) 800-5722 |
NPI Number | 1306236187 |
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Provider Enumeration Date | 01/30/2015 |
Last Update Date | 09/18/2023 |
Medicare PECOS PAC ID | 5193709392 |
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Medicare Enrollment ID | O20150313000918 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306236187 | NPI | - | NPPES |
3439028-01 | Medicaid | TX | |
74-1883 | Other | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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