Provider Demographics
NPI:1912862699
Name:ORTHOLONESTAR, PLLC
Entity type:Organization
Organization Name:ORTHOLONESTAR, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP QUALITY & REGULATORY AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-447-9004
Mailing Address - Street 1:4700 SETON CENTER PKWY STE 115
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5753
Mailing Address - Country:US
Mailing Address - Phone:346-440-0645
Mailing Address - Fax:
Practice Address - Street 1:1123 S PALESTINE ST STE 300
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-3645
Practice Address - Country:US
Practice Address - Phone:903-939-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOLONESTAR, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-12-16
Last Update Date:2025-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty