Provider Demographics
NPI:1659199776
Name:STAR CARE PROVIDER SERVICES, LLC
Entity type:Organization
Organization Name:STAR CARE PROVIDER SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-877-9098
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:BENAVIDES
Mailing Address - State:TX
Mailing Address - Zip Code:78341-0510
Mailing Address - Country:US
Mailing Address - Phone:361-877-9098
Mailing Address - Fax:361-256-3416
Practice Address - Street 1:1401 ELM ST #2705
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202
Practice Address - Country:US
Practice Address - Phone:361-877-9098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty