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General NPI Number Information
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NPI Number | 1306051529
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Entity Type | Organization
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Legal Business Name | STAR STAFFING
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 2695 VILLA CREEK DR STE 268
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City | DALLAS
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State | TX
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Zip | 75234-7329
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Country | US
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Telephone | 972-247-7000
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Fax | 972-247-7000
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Provider Business Mailing Address
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Address Line | 2695 VILLA CREEK DR STE 268
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City | DALLAS
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State | TX
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Zip | 75234-7329
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Country | US
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Telephone | 972-247-7000
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Fax | 972-247-7000
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Authorized Official
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Title or Position | CEO
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Name | MR. TRACY DWAYNE GARRICK
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Credential | CRT
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Telephone | 972-247-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0095479
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License Number State | TX
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