Provider Demographics
NPI:1992175509
Name:LONE STAR EVALUATIONS INC.
Entity type:Organization
Organization Name:LONE STAR EVALUATIONS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCSHANE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-476-4616
Mailing Address - Street 1:1500 WILDCAT DR STE M
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-2826
Mailing Address - Country:US
Mailing Address - Phone:281-476-4616
Mailing Address - Fax:
Practice Address - Street 1:1500 WILDCAT DR STE M
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TX
Practice Address - Zip Code:78374-2826
Practice Address - Country:US
Practice Address - Phone:281-476-4616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2753207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty