| Texas Lone Star Physician Services, Pllc | |
|
2005 E Bustamante St Laredo TX 78041-5470 | |
| (956) 753-5353 | |
| Not Available |
| Full Name | Texas Lone Star Physician Services, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2005 E Bustamante St, Laredo, Texas |
| Authorized Official Name and Position | Nelson Garay (CEO, PHYSICIAN) |
| Authorized Official Contact | 4322487417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Lone Star Physician Services, Pllc 987 Witherspoon Loop Laredo TX 78046-8823 Ph: (432) 248-7417 | Texas Lone Star Physician Services, Pllc 2005 E Bustamante St Laredo TX 78041-5470 Ph: (956) 753-5353 |
| NPI Number | 1265075618 |
|---|---|
| Provider Enumeration Date | 10/17/2019 |
| Last Update Date | 12/17/2019 |
| Medicare PECOS PAC ID | 0143653527 |
|---|---|
| Medicare Enrollment ID | O20191126001969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265075618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nelson A Garay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154795284 PECOS PAC ID: 7810283520 Enrollment ID: I20190806000505 |
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