Organization
LONE STAR ENDOSCOPY CENTER, LLC
Active
Other names
Lone Star Endoscopy Southlake
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BLACH (OFFICER/AUTHORIZED OFFICIAL)
(713) 343-0832
Entity
Organization
Contact information
Practice address
515 S NOLEN DR, SOUTHLAKE, TX 76092-9167
(817) 912-1999
Mailing address
515 S NOLEN DR, SOUTHLAKE, TX 76092-9167
(817) 912-1999
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2017
Last updated
10/11/2024
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