Provider Demographics
NPI:1710346242
Name:STARLA CENTER & SERVICES OF NORTH TEXAS
Entity Type:Organization
Organization Name:STARLA CENTER & SERVICES OF NORTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:401-447-2417
Mailing Address - Street 1:426 KELLER PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2361
Mailing Address - Country:US
Mailing Address - Phone:817-337-8200
Mailing Address - Fax:
Practice Address - Street 1:426 KELLER PKWY STE 600
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-2361
Practice Address - Country:US
Practice Address - Phone:817-337-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000000251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable