MEDICARE: STAR OF DAVID INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	347C00000X	Private Vehicle
2	347E00000X	Transportation Broker
3	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1538546486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR OF DAVID INC

Provider Business Mailing Address
First Line	:	3122 SPRINGDALE DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5101
Country	:	US
Telephone Number	:	832-275-2686
Fax Number	:	866-292-3523

Provider Business Practice Location Address
First Line	:	3122 SPRINGDALE DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5101
Country	:	US
Telephone Number	:	832-275-2686
Fax Number	:	866-292-3523

Authorized Official
Title or Position	:	CEO
Name	:	MR. ISREAL HOLMES
Credential	:
Telephone Number	:	832-275-2686

Provider Enumeration Date	:	04/29/2015
Last Update Date	:	03/06/2023

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Directions to “STAR OF DAVID INC ” Practice Location

Language	Start Address	Practice Location

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