Provider Demographics
NPI:1942949938
Name:LONESTAR URGENT CARE LLC
Entity type:Organization
Organization Name:LONESTAR URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:308-530-6286
Mailing Address - Street 1:1702 RODD FIELD RD STE 105
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-5027
Mailing Address - Country:US
Mailing Address - Phone:361-900-5782
Mailing Address - Fax:361-371-7270
Practice Address - Street 1:1702 RODD FIELD RD STE 105
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-5027
Practice Address - Country:US
Practice Address - Phone:361-900-5782
Practice Address - Fax:361-371-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care