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STAR PEDIATRIC GROUP PLLC NPI 1174008692


NPI Information

NPI: 1174008692
Provider Name: STAR PEDIATRIC GROUP PLLC

Doing Business As: STAR PEDIATRIC GROUP

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 45D2163784

Address:
541 W MAIN ST # 110
LEWISVILLE, TX
ZIP 75057
Phone: (718) 578-7866
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STAR PEDIATRIC GROUP PLLC is a pediatrics in Lewisville, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. STAR PEDIATRIC GROUP PLLC NPI is 1174008692. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Star Pediatric Group.

The provider's business location address is:

541 W MAIN ST # 110
LEWISVILLE, TX
ZIP 75057-628
Phone: (718) 578-7866

The provider's authorized official is Afser Tasneem .
The authorized official title is Partner and has the following contact phone number (718) 578-7866.

The CLIA number assigned to this NPI record is 45D2163784 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/1/2018 and was last updated on 10/15/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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