NPIMap

Organization Active NPI

Lone Star Circle of Care

  • Pediatrics Physician
  • Georgetown, TX
National Provider Identifier
1710169198
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LONE STAR CIRCLE OF CARE
Practice address
1500 W University Ave Ste 103
Georgetown, TX 78628-7109
Phone
(512) 868-1124
Fax
(512) 868-9894
NPI assigned
Nov 28, 2007
Last updated
Nov 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Mr. Peter C Perialas Jr.
Title
Ceo
Phone
(512) 868-1124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1500 W University Ave Ste 103
Georgetown, TX 78628-7109

Mailing address

1500 W University Ave Ste 103
Georgetown, TX 78628-7109
Phone (512) 868-1124

Other names 1

  • GCC Tx Health Steps Other name

National Provider Directory

National Provider Directory
Tax ID family
LSCC Georgetown Pharmacy- Williams Drive34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

1500 W University Ave
Ste 103
Georgetown, TX 78628
Phone (512) 341-8908

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1710169198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W UNIVERSITY AVE STE 103",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786287109",
            "telephone_number": "512-868-1124",
            "fax_number": "512-868-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W UNIVERSITY AVE STE 103",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786287109",
            "telephone_number": "512-868-1124",
            "fax_number": "512-868-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR CIRCLE OF CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "PERIALAS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-868-1124",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GCC Tx Health Steps",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.