MEDICARE: STAR OPTOMETRY AL, LLC

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1851164156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR OPTOMETRY AL, LLC

Provider Business Mailing Address
First Line	:	7501 PARAGON RD STE 201
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-5323
Country	:	US
Telephone Number	:	904-545-4465
Fax Number	:	256-880-1277

Provider Business Practice Location Address
First Line	:	8200 WHITESBURG DR SW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35802-3006
Country	:	US
Telephone Number	:	256-880-8058
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, REVENUE CYCLE MANAGEMENT
Name	:	CHRISTA WILLIAMS
Credential	:
Telephone Number	:	904-312-2295

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	02/04/2026

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