# LONE STAR PHARMACY

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

## Provider details

- **NPI number:** 1871775833
- **Authorized official:** SHANE LEWIS (PRESIDENT)
- **Authorized official phone:** (972) 303-7500

## Contact information

- **Practice address:** 12615 W AIRPORT BLVD, STE 200, SUGAR LAND, TX 77478-6202
- **Practice address phone:** (281) 242-1798
- **Practice address fax:** (281) 242-2165
- **Mailing address:** 1417 E INTERSTATE 30, STE 3, GARLAND, TX 75043-4786

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 25784 | TX | Yes |

## Other

- **Enumeration date:** 12/03/2007
- **Last updated:** 12/05/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4546480 | OTHER ID NUMBER | — |