Organization Active NPI

Star Care Family & Preventive Medicine

  • Family Medicine Physician
  • Irving, TX
National Provider Identifier
1902900244
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J8529 Issued in TX
Legal business name
STAR CARE FAMILY & PREVENTIVE MEDICINE
Practice address
1701 W Walnut Hill Lane
200
Irving, TX 75038-3215
Phone
(972) 594-1111
Fax
(972) 518-1867
NPI assigned
Sep 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ross E Dorman
Title
Chief Financial Officer
Phone
(972) 594-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X J8529 TX Primary

Addresses

Primary practice location

1701 W Walnut Hill Lane
200
Irving, TX 75038-3215

Mailing address

1701 W Walnut Hill Lane
200
Irving, TX 75038-3215
Phone (972) 594-1111

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
45D0723099Star Care Family & Preventive Medicine1701 W Walnut Hill Lane # 200, Irving, TX 75038Certificate of waiverJun 21, 2027

National Provider Directory

National Provider Directory

Locations

1701 W Walnut Hill Ln
Ste 103
Irving, TX 75038

1701 W Walnut Hill Ln
Ste 200
Irving, TX 75038
Phone (972) 594-1111

1701 W Walnut Hill Ln
Ste 450
Irving, TX 75038

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGDDCA

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902900244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W WALNUT HILL LANE",
            "address_2": "200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383215",
            "telephone_number": "972-594-1111",
            "fax_number": "972-518-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W WALNUT HILL LANE",
            "address_2": "200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383215",
            "telephone_number": "972-594-1111",
            "fax_number": "972-518-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR CARE FAMILY & PREVENTIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DORMAN",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "972-594-1111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J8529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.