Provider Demographics
NPI:1811955305
Name:STARR, ALICIA LEIGH (MD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:LEIGH
Last Name:STARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:LEIGH
Other - Last Name:LARITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75091-0340
Mailing Address - Country:US
Mailing Address - Phone:903-462-4184
Mailing Address - Fax:903-327-8023
Practice Address - Street 1:5016 US HWY 75
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4584
Practice Address - Country:US
Practice Address - Phone:903-462-4184
Practice Address - Fax:903-327-8023
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ45392085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83R239OtherCOLLIN COUNTY PTAN
TX125382503Medicaid
TX83R239OtherCOLLIN COUNTY PTAN