Northstar DX LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NORTHSTAR DX LLC

Practice address

12225 Greenville Ave Ste 880
Dallas, TX 75243-0513

Phone

(469) 259-2392

Fax

(972) 521-3385

NPI assigned

Jun 14, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Rose

Title

Owner

Phone

(469) 259-2392

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1164265500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12225 GREENVILLE AVE STE 880",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752430513",
            "telephone_number": "469-259-2392",
            "fax_number": "972-521-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12225 GREENVILLE AVE STE 880",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752430513",
            "telephone_number": "469-259-2392",
            "fax_number": "972-521-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR DX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-259-2392"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.