Organization Active NPI

Texas Lone Star Physician Services, PLLC

  • Family Medicine Physician
  • Laredo, TX
National Provider Identifier
1265075618
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TEXAS LONE STAR PHYSICIAN SERVICES, PLLC
Practice address
2005 E Bustamante St
Laredo, TX 78041-5470
Phone
(956) 753-5353
NPI assigned
Oct 17, 2019
Last updated
Dec 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Authorized official

Name
Dr. Nelson Garay, MDNPI 1154795284
Title
Ceo, Physician
Phone
(432) 248-7417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2005 E Bustamante St
Laredo, TX 78041-5470

Mailing address

987 Witherspoon Loop
Laredo, TX 78046-8823
Phone (432) 248-7417

Other practice location 1

2005A E Bustamante St
Laredo, TX 78041-5470
Phone (956) 764-8555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191126001969 TX Part B Supplier - Clinic/Group Practice 0143653527 Receives reassigned benefits from 1 practitioner
Practice locations: Laredo, TX

National Provider Directory

National Provider Directory

Locations

2005 E Bustamante St
#A
Laredo, TX 78041
Phone (956) 753-5353

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20928/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1265075618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987 WITHERSPOON LOOP",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780468823",
            "telephone_number": "432-248-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 E BUSTAMANTE ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415470",
            "telephone_number": "956-753-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005A E Bustamante St",
            "address_purpose": "LOCATION",
            "city": "Laredo",
            "state": "TX",
            "postal_code": "780415470",
            "country_code": "US",
            "telephone_number": "956-764-8555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS LONE STAR PHYSICIAN SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "GARAY",
        "authorized_official_first_name": "NELSON",
        "authorized_official_title_or_position": "CEO, PHYSICIAN",
        "authorized_official_telephone_number": "432-248-7417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.