# LONE STAR UROLOGY CONSULTANTS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336223817
- **Authorized official:** NANCY ORTLIP (OFFICE MANAGER)
- **Authorized official phone:** (580) 924-8884

## Contact information

- **Practice address:** 1323 N 16TH AVE, DURANT, OK 74701-2134
- **Practice address phone:** (580) 924-8884
- **Practice address fax:** (580) 924-8911
- **Mailing address:** PO BOX 456, DURANT, OK 74702-0456
- **Mailing address phone:** (580) 924-8884
- **Mailing address fax:** (580) 924-8911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 20400 | OK | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 01/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CJ8453 | RAILROAD MEDICARE | OK |