Provider Demographics
NPI:1326348038
Name:D-STAR
Entity Type:Organization
Organization Name:D-STAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPSILVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-564-2812
Mailing Address - Street 1:4665 FM 226
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-7123
Mailing Address - Country:US
Mailing Address - Phone:936-564-2812
Mailing Address - Fax:936-564-1982
Practice Address - Street 1:4665 FM 226
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-7123
Practice Address - Country:US
Practice Address - Phone:936-564-2812
Practice Address - Fax:936-564-1982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies