Active NPI
Star Pediatric Group PLLC
- Pediatrics Physician
- Lewisville, TX
National Provider Identifier
1174008692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- STAR PEDIATRIC GROUP PLLC
- Practice address
- 541 W Main St # 110
Lewisville, TX 75057-3628 - Phone
- (718) 578-7866
- NPI assigned
- Oct 1, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Afser Tasneem, MD
- Title
- Partner
- Phone
- (718) 578-7866
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
541 W Main St # 110
Lewisville, TX 75057-3628
Mailing address
PO Box 3888
Coppell, TX 75019-4310
Phone (718) 578-7866
Other names 1
- Star Pediatric Group
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2163784 | Star Pediatric Group | Certificate of waiver | Mar 20, 2027 |
National Provider Directory
National Provider DirectoryLocations
541 W Main St
Ste 110
Lewisville, TX 75057
Phone (469) 702-6633
Interoperability endpoints
- https://api.platform.athenahealth.com/18695/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1571097600000",
"number": "1174008692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3888",
"city": "COPPELL",
"state": "TX",
"postal_code": "750194310",
"telephone_number": "718-578-7866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 W MAIN ST # 110",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750573628",
"telephone_number": "718-578-7866"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STAR PEDIATRIC GROUP PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-01",
"last_updated": "2019-10-15",
"status": "A",
"authorized_official_last_name": "TASNEEM",
"authorized_official_first_name": "AFSER",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "718-578-7866",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Star Pediatric Group",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.