Provider Demographics
NPI:1942386297
Name:ALL STAR MEDICAL
Entity Type:Organization
Organization Name:ALL STAR MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:GAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-251-5977
Mailing Address - Street 1:1101 PECAN ST W STE 8
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2607
Mailing Address - Country:US
Mailing Address - Phone:512-251-5977
Mailing Address - Fax:512-251-6017
Practice Address - Street 1:10625 RICHMOND AVE STE 140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4906
Practice Address - Country:US
Practice Address - Phone:512-251-5977
Practice Address - Fax:512-251-6017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
0880000001Medicare ID - Type Unspecified