| Lone Star Circle Of Care At Lake Aire Medical Center | |
|
2423 Williams Dr Georgetown TX 78628-3200 | |
| (877) 800-5722 | |
| Not Available |
| Full Name | Lone Star Circle Of Care At Lake Aire Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2423 Williams Dr, Georgetown, 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 |
|---|---|
| Lone Star Circle Of Care At Lake Aire Medical Center 205 E University Ave Suite 200 Georgetown TX 78626-6814 Ph: (877) 800-5722 | Lone Star Circle Of Care At Lake Aire Medical Center 2423 Williams Dr Georgetown TX 78628-3200 Ph: (877) 800-5722 |
| NPI Number | 1669603361 |
|---|---|
| Provider Enumeration Date | 07/30/2009 |
| Last Update Date | 09/18/2023 |
| Medicare PECOS PAC ID | 5193709392 |
|---|---|
| Medicare Enrollment ID | O20100115000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669603361 | NPI | - | NPPES |
| 2085110-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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