Provider Demographics
NPI:1679826895
Name:STAR RENAL CARE, PLLC
Entity Type:Organization
Organization Name:STAR RENAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAREHA
Authorized Official - Middle Name:ABID
Authorized Official - Last Name:KAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-960-9846
Mailing Address - Street 1:8668 JOHN HICKMAN PKWY STE 1003
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9388
Mailing Address - Country:US
Mailing Address - Phone:469-200-5764
Mailing Address - Fax:214-556-1186
Practice Address - Street 1:8668 JOHN HICKMAN PKWY STE 1003
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:214-842-8743
Practice Address - Fax:214-556-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0985207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110C311580OtherBCN
TXTXB146890Medicare PIN
TXTXB146889Medicare PIN
TXH72782Medicare UPIN
TXB146891Medicare PIN