Star Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

STAR DERMATOLOGY PLLC

Practice address

783 N Denton Tap Rd Ste 150
Coppell, TX 75019-2129

Phone

(469) 289-2660

NPI assigned

Apr 12, 2023

Last updated

Apr 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ikechukwu Okolocha, NP-CNPI 1275044851

Title

Owner

Phone

(469) 289-2660

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ikechukwu Henry Okolocha, FNP

  • Nurse Practitioner
  • Coppell, TX
  • NPI 1275044851
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1750077889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "783 N DENTON TAP RD STE 150",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192129",
            "telephone_number": "469-289-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "783 N DENTON TAP RD STE 150",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192129",
            "telephone_number": "469-289-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "OKOLOCHA",
        "authorized_official_first_name": "IKECHUKWU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-289-2660",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori B Spors
• Meagan Taylor Springer, DPT
• Brittany Spruiell, DDS
• Ava Cheryl Stanczak, D.O.
• Breunha Stapleton
• Star Health & Rehab PA
• Star Health & Rehab, PA
• Star Neuro PLLC
• Star Orthopedics and Sports Medicine PLLC
• Andrea Marie Starr

• Dermatology Physician in Coppell, TX
• Providers in Coppell, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.