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General NPI Number Information
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NPI Number | 1033939863
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Entity Type | Organization
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Legal Business Name | STAR ORTHOPEDICS AND SPORTS MEDICINE PLLC
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 149 E STATE HIGHWAY 121 STE 115
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City | COPPELL
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State | TX
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Zip | 75019-7985
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Country | US
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Telephone | 469-850-0680
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Fax | 469-850-0681
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Provider Business Mailing Address
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Address Line | 5550 WARREN PKWY STE 230
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City | FRISCO
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State | TX
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Zip | 75034-7330
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Country | US
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Telephone | 972-616-4000
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Fax | 972-294-3343
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Authorized Official
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Title or Position | OWNER/MD
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Name | ANDREW PETER DOLD
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Credential |
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Telephone | 469-850-0680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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