Lone Star Endoscopy Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LONE STAR ENDOSCOPY CENTER, LLC

Practice address

515 S Nolen Dr
Southlake, TX 76092-9167

Phone

(817) 912-1999

NPI assigned

Jul 18, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peter Blach

Title

Officer/Authorized Official

Phone

(713) 343-0832

Specialties & licenses 1

Addresses

Other names 1

• Lone Star Endoscopy Southlake Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lone Star Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Keller, TX
  • NPI 1336459353

  O20110524000715

  Same enrollment
• Lone Star Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Flower Mound, TX
  • NPI 1316359532

  O20110524000715

  Same enrollment

Listed as

Lone Star Endoscopy Center SouthlakeCCN 45C0001646

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Ability Network3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Lone Star Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Keller, TX
  • NPI 1336459353
  NPD tax ID
• Lone Star Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Flower Mound, TX
  • NPI 1316359532
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1154844553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S NOLEN DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929167",
            "telephone_number": "817-912-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S NOLEN DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929167",
            "telephone_number": "817-912-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "BLACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-343-0832"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lone Star Endoscopy Southlake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lone Star Endoscopy Southlake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosemary Lockard, LMT
• Kimberley Loesch, RPH
• Allison Loftin
• Laura Barham Loftin, LCSW
• Arleny Lomas
• Corey Thomas Long, PT
• Jennifer Long
• Esther Longe, FNP-C
• Marissa Lonngi, LPC
• Kimberly Lopez

• Ambulatory Surgical Clinic/Center in Southlake, TX
• Providers in Southlake, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.