Provider Demographics
NPI:1225573603
Name:SILVER STAR MEDICAL RESOURCES, LLC
Entity Type:Organization
Organization Name:SILVER STAR MEDICAL RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-442-8908
Mailing Address - Street 1:PO BOX 821868
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75382-1868
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:214-442-8907
Practice Address - Street 1:1905 W ENNIS AVE STE 500
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-3627
Practice Address - Country:US
Practice Address - Phone:214-442-8908
Practice Address - Fax:214-442-8907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0036174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty