Provider Demographics
NPI:1912371998
Name:STARR, DARRICK (R EEG TECH)
Entity Type:Individual
Prefix:MR
First Name:DARRICK
Middle Name:
Last Name:STARR
Suffix:
Gender:M
Credentials:R EEG TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4622 LAKEPOINTE AVE
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-6861
Mailing Address - Country:US
Mailing Address - Phone:214-437-1932
Mailing Address - Fax:
Practice Address - Street 1:4622 LAKEPOINTE AVE
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-6861
Practice Address - Country:US
Practice Address - Phone:214-437-1932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3128246ZE0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG