MEDICARE: MERELINE STARLING LVN

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	311ZA0620X	Adult Care Home Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000863500	OTHER	TX	API
2	136722	OTHER	TX	ADULT FOSTER CARE LICENSE

General Provider Information

NPI Number	:	1588024277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERELINE STARLING LVN

Provider Business Mailing Address
First Line	:	PO BOX 21
Second Line	:
City	:	HENDERSON
State	:	TX
Zip	:	75653-0021
Country	:	US
Telephone Number	:	903-657-4304
Fax Number	:

Provider Business Practice Location Address
First Line	:	4285 HWY 259 SOUTH
Second Line	:
City	:	HENDERSON
State	:	TX
Zip	:	75654-5133
Country	:	US
Telephone Number	:	903-649-1326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2016
Last Update Date	:	08/04/2021

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