Provider Demographics
NPI:1346915782
Name:TEXAS STAR BIO MED LLC
Entity Type:Organization
Organization Name:TEXAS STAR BIO MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-997-8630
Mailing Address - Street 1:4749 FREDERICKSBURG RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4465
Mailing Address - Country:US
Mailing Address - Phone:210-977-8630
Mailing Address - Fax:866-291-1359
Practice Address - Street 1:4749 FREDERICKSBURG RD STE A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4465
Practice Address - Country:US
Practice Address - Phone:210-997-8630
Practice Address - Fax:210-733-1808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty