Healthcare Provider Details

I. General information

NPI: 1013513753
Provider Name (Legal Business Name): STAR PLUS DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 04/30/2024
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N BROADWAY STE B UNIT 5
ELSA TX
78543
US

IV. Provider business mailing address

PO BOX 459
WESLACO TX
78599-0459
US

V. Phone/Fax

Practice location:
  • Phone: 956-246-3829
  • Fax:
Mailing address:
  • Phone: 956-567-2093
  • Fax: 956-567-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. REYMUNDO MERCADO
Title or Position: CEO
Credential:
Phone: 956-246-5980