Provider Demographics
NPI:1700773801
Name:STARRANCHBRACES PLLC
Entity type:Organization
Organization Name:STARRANCHBRACES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIRALI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHBAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-351-8362
Mailing Address - Street 1:1700 W PARMER LN STE 250
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-4609
Mailing Address - Country:US
Mailing Address - Phone:512-351-8362
Mailing Address - Fax:
Practice Address - Street 1:20808 N STATE HIGHWAY 130 STE 220
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-2738
Practice Address - Country:US
Practice Address - Phone:512-351-8362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty