Provider Demographics
NPI:1558979443
Name:STAR NEUROPSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:STAR NEUROPSYCHOLOGY, PLLC
Other - Org Name:STAR NEUROPSYCHOLOGY, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHDAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-730-1177
Mailing Address - Street 1:8992 PRESTON RD STE 110-760
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3965
Mailing Address - Country:US
Mailing Address - Phone:415-730-1177
Mailing Address - Fax:
Practice Address - Street 1:9741 PRESTON RD STE 203
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-2554
Practice Address - Country:US
Practice Address - Phone:415-730-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service