Provider Demographics
NPI:1932143542
Name:STARKS, HERBERT LEE JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:LEE
Last Name:STARKS
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 DOGWOOD AVE APT 10C
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245
Mailing Address - Country:US
Mailing Address - Phone:510-260-7706
Mailing Address - Fax:
Practice Address - Street 1:899 DOGWOOD AVE
Practice Address - Street 2:APT 10C
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245
Practice Address - Country:US
Practice Address - Phone:510-260-7706
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32392225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist