Organization
LONE STAR ANESTHESIA CONSULTANTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BRUCE PISTOCCO M.D. (PARTNER)
(806) 355-9595
Entity
Organization
Contact information
Practice address
1501 S COULTER ST, AMARILLO, TX 79106-1770
(806) 354-1000
Mailing address
PO BOX 2656, BRYAN, TX 77805-2656
(806) 355-9595
(806) 353-1589
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD2066
RR MEDICARE
GA
Enumeration date
05/16/2006
Last updated
04/18/2008
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