Provider Demographics
NPI:1003707787
Name:LONE STAR MEDICAL THERAPY PLLC
Entity type:Organization
Organization Name:LONE STAR MEDICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYCEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-702-2977
Mailing Address - Street 1:302 S CENTRAL ST STE C8
Mailing Address - Street 2:
Mailing Address - City:HALLSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75650-6202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:302 S CENTRAL ST
Practice Address - Street 2:
Practice Address - City:HALLSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75650-6202
Practice Address - Country:US
Practice Address - Phone:903-702-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty