Provider Demographics
NPI:1760203889
Name:LONE STAR PSYCHOLOGY
Entity type:Organization
Organization Name:LONE STAR PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BRITANI
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:214-636-0331
Mailing Address - Street 1:128 COUNTY ROAD 850
Mailing Address - Street 2:
Mailing Address - City:BUNA
Mailing Address - State:TX
Mailing Address - Zip Code:77612-3404
Mailing Address - Country:US
Mailing Address - Phone:214-636-0331
Mailing Address - Fax:
Practice Address - Street 1:128 COUNTY ROAD 850
Practice Address - Street 2:
Practice Address - City:BUNA
Practice Address - State:TX
Practice Address - Zip Code:77612-3404
Practice Address - Country:US
Practice Address - Phone:214-636-0331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty