Lone Star Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

130072 Issued in TX

Legal business name

LONE STAR ENDOSCOPY CENTER LLC

Practice address

180 Bear Creek Pkwy
Keller, TX 76248-2500

Phone

(817) 337-3671

Fax

(817) 337-3620

NPI assigned

Oct 8, 2010

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 identifiers 1

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
  • Southlake, TX
  • NPI 1154844553

  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 LLCCCN 45C0001422

Medicare certification status

ActiveFrom the Provider of Services file

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
  • Southlake, TX
  • NPI 1154844553
  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": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1336459353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 BEAR CREEK PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482500",
            "telephone_number": "817-337-3671",
            "fax_number": "817-337-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 BEAR CREEK PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482500",
            "telephone_number": "817-337-3671",
            "fax_number": "817-337-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "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": "TX",
            "license": "130072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00973173",
            "state": "TX"
        }
    ],
    "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": []
}

• Live Again Surgical
• Lakenya Livingston
• Logos Services LLC
• Toni Lombardi, PSY-D
• Heaven Londot, D.C.
• Lone Star Endoscopy, LLP
• Lone Star Lactation
• Lone Star Med Spa and Health LLC
• Stefanie Long, DPT
• Ana I. Lopez, M.D.

• Ambulatory Surgical Clinic/Center in Keller, TX
• Providers in Keller, 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.