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NPI Code Detail

MEDICARE: ALL STAR TRUST

MEDICARE: ALL STAR TRUST
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
12279P1004XPulmonary Diagnostics Registered Respiratory Therapist54207TX

General Provider Information

NPI Number : 1164620985
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALL STAR TRUST
Provider Business Mailing Address
First Line : 3007 MAPLE AVE
Second Line :
City : DALLAS
State : TX
Zip : 75201-1243
Country : US
Telephone Number : 888-286-2292
Fax Number : 888-286-2292
Provider Business Practice Location Address
First Line : 3007 MAPLE AVE
Second Line :
City : DALLAS
State : TX
Zip : 75201-1243
Country : US
Telephone Number : 888-286-2292
Fax Number : 888-286-2292
Authorized Official
Title or Position : CEO
Name : SHERRI MCKNIGHT
Credential :
Telephone Number : 888-286-2292
Provider Enumeration Date : 07/03/2007
Last Update Date : 03/19/2008

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Directions to “ALL STAR TRUST ” Practice Location

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