Blue Star Rehabilitation Plano LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLUE STAR REHABILITATION PLANO LLC

Doing business as

Blue Star Family Medicine

Practice address

17754 Preston Rd Ste 100
Dallas, TX 75252-5638

Phone

(972) 476-9036

Fax

(972) 476-9926

NPI assigned

Apr 9, 2020

Last updated

Oct 2, 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

Mr. Chris Paul Green

Title

Owner

Phone

(972) 445-4134

Specialties & licenses 1

Addresses

Other names 1

• Blue Star Family Medicine Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1902425093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W AIRPORT FWY # 959",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750626312",
            "telephone_number": "972-445-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17754 PRESTON RD STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525638",
            "telephone_number": "972-476-9036",
            "fax_number": "972-476-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE STAR REHABILITATION PLANO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-445-4134",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Phone",
            "affiliation": "N",
            "address_1": "2600 Avenue K",
            "address_2": "160",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Blue Star Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Star Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.