Basic Information
| Provider Information | |||||||||
| NPI: | 1134600380 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STAR ANESTHESIA ASSOCIATES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5999 CUSTER RD STE 110 #522 | ||||||||
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| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750359304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728728408 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7000 PRESTON RD STE 1200 | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750242512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728728408 | ||||||||
| FaxNumber: | 9728507352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2018 | ||||||||
| LastUpdateDate: | 08/26/2018 | ||||||||
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| AuthorizedOfficialLastName: | GHALAMBOR | ||||||||
| AuthorizedOfficialFirstName: | OMID | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9728728408 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.