Organization
LONE STAR CIRCLE OF CARE
Active
Other names
Georgetown Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER C PERIALAS JR. (CEO)
(512) 868-1124
Entity
Organization
Contact information
Practice address
701 E UNIVERSITY AVE, GEORGETOWN, TX 78626-7035
(512) 863-8208
(512) 864-7238
Mailing address
205 E UNIVERSITY AVE, SUITE 200, GEORGETOWN, TX 78626-6814
(512) 868-1124
(512) 868-9894
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1560575-05
—
TX
Enumeration date
05/10/2006
Last updated
03/03/2011
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