Healthcare Provider Details

I. General information

NPI: 1427967249
Provider Name (Legal Business Name): DRAGON STAR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR STE S
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

8401 MAYLAND DR STE S
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 540-200-5135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084B0002X
TaxonomyObesity Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA GALICKI
Title or Position: OWNER
Credential:
Phone: 540-200-5135