Lone Star Circle of Care
Organization Active NPI Federally Qualified Health Center (FQHC) · Georgetown, TX
NPI 1750331963 · NPPES record last updated Mar 3, 2011
Key facts
- NPI
- 1750331963
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- LONE STAR CIRCLE OF CARE
- Practice address
- 701 E University Ave
Georgetown, TX 78626-7035 - Phone
- (512) 863-8208
- Fax
- (512) 864-7238
- NPI assigned
- May 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Peter C Perialas Jr.
- Title
- Ceo
- Phone
- (512) 868-1124
Other NPIs on the same Medicare enrollment 39
Practitioners 17
-
Pedro Bustamante, LMSW
-
Truett Barron Clifton, WHNP
-
Kristie Dawn Engel, PH.D.
-
Benjamin Paul Fiedler, M.D.
-
Virginia Garay, MD
-
Abhilasha Gupta, MD
-
Natacha Pankratz, M.D.
-
Shreeya Parajuli, M.D.
-
Jane Kana Shepherd, M.D.
-
Meenu Singh, MD
-
Raymond Gebhart Spaw, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040622000184 | TX | Part B Supplier - Clinic/Group Practice | 5193709392 |
Receives reassigned benefits from 181 practitioners 39 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Austin, TX; Taylor, TX; Round Rock, TX; Pflugerville, TX; Killeen, TX; Jonestown, TX; Hutto, TX; Harker Heights, TX… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
701 E University Ave
Georgetown, TX 78626-7035
Mailing address
205 E University Ave
Suite 200
Georgetown, TX 78626-6814
Phone (512) 868-1124
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1560575-05 | Medicaid | TX |
Other names
- Georgetown Community Clinic
Other providers in Georgetown, TX
- Lone Star Circle of Care
- Lone Star Circle of Care
- Lone Star Circle of Care
- Lone Star Circle of Care
- Lone Star Circle of Care
- Lone Star Circle of Care
- Lone Star Circle of Care
- Lone Star Circle of Care
- Lone Star Circle of Care
- Lone Star Circle of Care
All providers in Georgetown, TX · Federally Qualified Health Center (FQHC) in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.