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General NPI Number Information
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NPI Number | 1700773801
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Entity Type | Organization
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Legal Business Name | STARRANCHBRACES PLLC
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 20808 N STATE HIGHWAY 130 STE 220
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City | HUTTO
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State | TX
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Zip | 78634-2738
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Country | US
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Telephone | 512-351-8362
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 W PARMER LN STE 250
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City | AUSTIN
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State | TX
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Zip | 78727-4609
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Country | US
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Telephone | 512-351-8362
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST/MANAGER
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Name | DR. AMIRALI TAHBAZ
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Credential | DDS
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Telephone | 512-351-8362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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