Provider Demographics
NPI:1205251733
Name:TEXAS STAR PHYSICIANS ALLIANCE LLC
Entity type:Organization
Organization Name:TEXAS STAR PHYSICIANS ALLIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEIRF
Authorized Official - Middle Name:
Authorized Official - Last Name:LATIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-250-7440
Mailing Address - Street 1:1501 S LOOP 288
Mailing Address - Street 2:SUITE 104 PMB 194
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4703
Mailing Address - Country:US
Mailing Address - Phone:520-250-7440
Mailing Address - Fax:
Practice Address - Street 1:3100 PETERS COLONY RD
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2949
Practice Address - Country:US
Practice Address - Phone:214-513-0310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty