| Organization Name: | LONE STAR CIRCLE OF CARE |
| NPI Number: | 1003051673 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PETER C PERIALAS (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 905 Ih 35 N Suite 109 Round Rock |
| State: | TX US |
| Postal Code: | 786644254 |
| Phone Number: | 5127332100 |
| Fax Number: | 5127332101 |
| NPI Enumeration Date: | 12/10/2008 |
| NPI Last Update Date: | 12/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |