Healthcare Provider Details

I. General information

NPI: 1740283076
Provider Name (Legal Business Name): CAROL L STARR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL L STARR FNP

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 S LANCASTER RD
DALLAS TX
75216-4531
US

IV. Provider business mailing address

1380 RIVER BEND DR
DALLAS TX
75247-4914
US

V. Phone/Fax

Practice location:
  • Phone: 214-371-6639
  • Fax: 214-372-6199
Mailing address:
  • Phone: 214-743-6159
  • Fax: 214-689-6482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number225319
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: