Star Surgical Services
Clinic/Center in Grapevine, TX. Organization (NPI-2).
NPI number1700428331
StatusActive
Last updated in NPPESOct 15, 2019
Details
- NPI
- 1700428331
- Entity type
- Organization (NPI-2)
- Legal business name
- Star Surgical Services
- Organization subpart
- No
- Enumeration date
- Oct 15, 2019
- Last updated
- Oct 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
1631 Lancaster Dr Ste 240Grapevine, TX 76051-3586
Phone 817-741-4144
Mailing address
405 Stockton DrSouthlake, TX 76092-2229
Authorized official
Shari Kushwaha
Member/Physician
8173122246
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