Organization
LONE STAR PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE LEWIS (PRESIDENT)
(972) 303-7500
Entity
Organization
Contact information
Practice address
12615 W AIRPORT BLVD, STE 200, SUGAR LAND, TX 77478-6202
(281) 242-1798
(281) 242-2165
Mailing address
1417 E INTERSTATE 30, STE 3, GARLAND, TX 75043-4786
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
25784
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4546480
OTHER ID NUMBER
—
Enumeration date
12/03/2007
Last updated
12/05/2007
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