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Organization
LONE STAR ENDOSCOPY CENTER LLC
Active
Organization
LONE STAR ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BLACH (OFFICER/AUTHORIZED OFFICIAL)
(713) 343-0832
Entity
Organization
Contact information
Practice address
180 BEAR CREEK PKWY, KELLER, TX 76248-2500
(817) 337-3671
(817) 337-3620
Mailing address
180 BEAR CREEK PKWY, KELLER, TX 76248-2500
(817) 337-3671
(817) 337-3620
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
130072
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00973173
RAILROAD MEDICARE
TX
Enumeration date
10/08/2010
Last updated
10/11/2024
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