| Lone Star Gastroenterology, P.a. | |
|
4101 W Spring Creek Pkwy Suite 400 Plano TX 75024-5307 | |
| (972) 867-7070 | |
| (972) 867-7878 |
| Full Name | Lone Star Gastroenterology, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4101 W Spring Creek Pkwy, Plano, Texas |
| Authorized Official Name and Position | Gowri Balachandar (PRESIDENT) |
| Authorized Official Contact | 9728677070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Star Gastroenterology, P.a. 4101 W Spring Creek Pkwy Suite 400 Plano TX 75024-5307 Ph: (972) 867-7070 | Lone Star Gastroenterology, P.a. 4101 W Spring Creek Pkwy Suite 400 Plano TX 75024-5307 Ph: (972) 867-7070 |
| NPI Number | 1295870152 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 03/26/2014 |
| Medicare PECOS PAC ID | 3476630039 |
|---|---|
| Medicare Enrollment ID | O20080407000287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295870152 | NPI | - | NPPES |
| 158049001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | K4363 (Texas) | Primary |
| Provider Name | Gowri Balachandar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669435889 PECOS PAC ID: 6709891641 Enrollment ID: I20101012001246 |
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