Provider Demographics
NPI:1902782352
Name:LONESTAR HEALTHCARE DALLAS
Entity type:Organization
Organization Name:LONESTAR HEALTHCARE DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGBAG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-459-1894
Mailing Address - Street 1:10723 SCHROEDER OAK CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4815
Mailing Address - Country:US
Mailing Address - Phone:713-459-1894
Mailing Address - Fax:
Practice Address - Street 1:4222 TRINITY MILLS RD STE 112
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7660
Practice Address - Country:US
Practice Address - Phone:214-764-3004
Practice Address - Fax:214-764-5334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty