Organization Active NPI

Star Pediatric Group PLLC

  • Pediatrics Physician
  • Lewisville, TX
National Provider Identifier
1174008692
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
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

Updated by the provider on Oct 15, 2019

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)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2163784Star Pediatric Group541 W Main St Suite 110, Lewisville, TX 75057Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Locations

541 W Main St
Ste 110
Lewisville, TX 75057
Phone (469) 702-6633

Interoperability endpoints

  • FHIR API: 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.

Verify at the official NPI Registry.