Provider Demographics
NPI:1578958070
Name:LONE STAR SURGICAL PARTNERS, PA
Entity type:Organization
Organization Name:LONE STAR SURGICAL PARTNERS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAILERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-741-5910
Mailing Address - Street 1:PO BOX 272109
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77277-2109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:713-583-1113
Practice Address - Street 1:12121 RICHMOND AVE STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2420
Practice Address - Country:US
Practice Address - Phone:281-741-5910
Practice Address - Fax:713-583-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty