Provider Demographics
NPI:1093525784
Name:LSTAR PSYCHIATRIC CLINIC LLC
Entity type:Organization
Organization Name:LSTAR PSYCHIATRIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:NZI
Authorized Official - Last Name:MORO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:713-410-8595
Mailing Address - Street 1:140 CLOVERLEAF DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2442
Mailing Address - Country:US
Mailing Address - Phone:713-410-8595
Mailing Address - Fax:
Practice Address - Street 1:140 CLOVERLEAF DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2442
Practice Address - Country:US
Practice Address - Phone:713-410-8595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty