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General NPI Number Information
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NPI Number | 1194804716
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Entity Type | Organization
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Legal Business Name | STAR CPD SERVICES LLC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 513 COUNTY ROAD 3640
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City | SULPHUR SPRINGS
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State | TX
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Zip | 75482-3650
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Country | US
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Telephone | 866-586-8919
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Fax | 866-586-8918
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Provider Business Mailing Address
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Address Line | 511 COUNTY ROAD 3640
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City | SULPHUR SPRINGS
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State | TX
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Zip | 75482-6917
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Country | US
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Telephone | 866-586-8919
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Fax | 866-586-8918
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Authorized Official
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Title or Position | MANAGER
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Name | VIRGINIA L DAVIS
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Credential | MS
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Telephone | 866-586-8919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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