MEDICARE: ALL-STAR ORTHOPAEDICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1205586997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL-STAR ORTHOPAEDICS

Provider Business Mailing Address
First Line	:	901 W BARDIN RD STE 100
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-6000
Country	:	US
Telephone Number	:	817-200-6492
Fax Number	:

Provider Business Practice Location Address
First Line	:	7501 LAS COLINAS BLVD STE 125
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7004
Country	:	US
Telephone Number	:	501-580-8352
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALIN
Name	:	NICOLE TATE
Credential	:
Telephone Number	:	817-200-6492

Provider Enumeration Date	:	03/25/2022
Last Update Date	:	03/25/2022

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Directions to “ALL-STAR ORTHOPAEDICS ” Practice Location

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