Provider Demographics
NPI:1629654702
Name:TEXAS-STAR PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:TEXAS-STAR PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENELICHI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:832-545-4039
Mailing Address - Street 1:PO BOX 710977
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77271-0977
Mailing Address - Country:US
Mailing Address - Phone:281-660-8661
Mailing Address - Fax:281-407-4516
Practice Address - Street 1:10103 FONDREN RD STE 150A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4556
Practice Address - Country:US
Practice Address - Phone:281-660-8661
Practice Address - Fax:281-407-4516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty