| Lonestar Visiting Physicians LLC | |
|
4115 Medical Dr Ste 301 San Antonio TX 78229-5622 | |
| (210) 390-6911 | |
| (210) 890-8711 |
| Full Name | Lonestar Visiting Physicians LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 4115 Medical Dr Ste 301, San Antonio, Texas |
| Authorized Official Name and Position | Alexis Southwell (OWNER) |
| Authorized Official Contact | 2104008460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lonestar Visiting Physicians LLC 4115 Medical Dr Ste 301 San Antonio TX 78229-5622 Ph: (210) 390-6911 | Lonestar Visiting Physicians LLC 4115 Medical Dr Ste 301 San Antonio TX 78229-5622 Ph: (210) 390-6911 |
| NPI Number | 1609414937 |
|---|---|
| Provider Enumeration Date | 12/17/2019 |
| Last Update Date | 01/06/2025 |
| Certification Date | 01/06/2025 |
| Medicare PECOS PAC ID | 7517395312 |
|---|---|
| Medicare Enrollment ID | O20200310000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609414937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | David a Marks |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1821016023 PECOS PAC ID: 1254416340 Enrollment ID: I20080313000474 |
| Provider Name | Caridad M Rebollar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073598520 PECOS PAC ID: 3072422823 Enrollment ID: I20090902000221 |
| Provider Name | Dusty R Wilkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396045506 PECOS PAC ID: 4486837044 Enrollment ID: I20110321000403 |
| Provider Name | Johnny Ray Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336824721 PECOS PAC ID: 1759516388 Enrollment ID: I20241115004041 |
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