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General NPI Number Information
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NPI Number | 1003132994
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Entity Type | Organization
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Legal Business Name | MEDSTAR CARE CENTER INC
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 04/16/2010
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Provider Practice Location Address
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Address Line | 1747 E HEMPSTEAD ST
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City | GIDDINGS
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State | TX
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Zip | 78942-3632
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Country | US
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Telephone | 979-542-2150
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Fax | 979-542-0755
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Provider Business Mailing Address
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Address Line | 2704 BLACKSTONE CV
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City | ROUND ROCK
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State | TX
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Zip | 78665-7892
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Country | US
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Telephone | 512-698-9010
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | FAYEZ Y MOHAMMED
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Credential |
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Telephone | 512-698-9010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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