Provider Demographics
NPI:1396055281
Name:LONE STAR CARDIAC ARRHYTHMIA, P.C.
Entity type:Organization
Organization Name:LONE STAR CARDIAC ARRHYTHMIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHUTICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-615-6224
Mailing Address - Street 1:7215 WYOMING SPRINGS DR.
Mailing Address - Street 2:BLDG. 1, STE. 100
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4311
Mailing Address - Country:US
Mailing Address - Phone:512-615-6224
Mailing Address - Fax:512-615-0459
Practice Address - Street 1:311 CAMDEN ST
Practice Address - Street 2:SUITE 216
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-2012
Practice Address - Country:US
Practice Address - Phone:210-212-5331
Practice Address - Fax:210-212-5315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty