Provider Demographics
NPI:1720669526
Name:STARR, AMY CHRISTINE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CHRISTINE
Last Name:STARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20647 ROSEHILL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-5808
Mailing Address - Country:US
Mailing Address - Phone:832-257-1321
Mailing Address - Fax:
Practice Address - Street 1:13406 MEDICAL COMPLEX DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3332
Practice Address - Country:US
Practice Address - Phone:281-517-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX660120163W00000X
TXAP142226363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse