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General NPI Number Information
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NPI Number | 1720404536
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Entity Type | Organization
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Legal Business Name | TEXAS STAR ANESTHESIA MANAGEMENT, LLP
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 4020 MCEWEN RD SUITE 177
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City | DALLAS
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State | TX
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Zip | 75244-5019
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Country | US
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Telephone | 214-437-4801
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Fax | 972-377-3473
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Provider Business Mailing Address
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Address Line | PO BOX 702097
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City | DALLAS
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State | TX
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Zip | 75370-2097
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Country | US
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Telephone | 214-437-4801
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Fax | 972-377-3473
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Authorized Official
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Title or Position | GENERAL MANAGING PARTNER
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Name | DR. JERRON CARLYLE HILL
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Credential | M.D.
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Telephone | 214-437-4801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | L4969
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License Number State | TX
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