MEDICARE: .SUNSTAR GERIATRICS HEALTHCARE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	K9039	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033151428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	.SUNSTAR GERIATRICS HEALTHCARE PA

Provider Business Mailing Address
First Line	:	501 S AUSTIN AVE
Second Line	:	SUITE 1320
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-5610
Country	:	US
Telephone Number	:	512-868-9078
Fax Number	:	512-819-0646

Provider Business Practice Location Address
First Line	:	501 S AUSTIN AVE
Second Line	:	SUITE 1320
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-5610
Country	:	US
Telephone Number	:	512-868-9078
Fax Number	:	512-819-0646

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. MARYANN M CHOI
Credential	:	M.D.
Telephone Number	:	512-868-9078

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	04/14/2009

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Directions to “.SUNSTAR GERIATRICS HEALTHCARE PA ” Practice Location

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