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Organization
LONE STAR FAMILY PRACTICE, PA
Active
Organization
LONE STAR FAMILY PRACTICE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDHA R JOGIMAHANTI MD (PRESIDENT)
(817) 269-2964
Entity
Organization
Contact information
Practice address
9800 N BEACH ST STE 508, FORT WORTH, TX 76244-6473
(817) 890-9111
(866) 939-1308
Mailing address
PO BOX 39, ROANOKE, TX 76262-0039
(817) 269-2964
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/26/2020
Last updated
11/15/2023
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