Provider Demographics
NPI:1104676386
Name:STAR PAIN MANAGEMENT EQUIPMENT LLC
Entity type:Organization
Organization Name:STAR PAIN MANAGEMENT EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMJID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-355-6616
Mailing Address - Street 1:1880 S DAIRY ASHFORD RD STE 207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-4759
Mailing Address - Country:US
Mailing Address - Phone:346-355-6616
Mailing Address - Fax:
Practice Address - Street 1:1880 S DAIRY ASHFORD RD STE 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4759
Practice Address - Country:US
Practice Address - Phone:346-355-6616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies