Organization
LONESTAR NEPHROLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROSPERITY EZEANUNA MD (PRESIDENT)
(979) 402-2115
Entity
Organization
Contact information
Practice address
2310 DE LEE ST STE 300, BRYAN, TX 77802-2815
(979) 485-9401
Mailing address
PO BOX 6084, BRYAN, TX 77805-6084
(979) 485-9401
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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