Provider Demographics
NPI:1366724387
Name:STARR DME & PHARMACY INC.
Entity type:Organization
Organization Name:STARR DME & PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-271-4258
Mailing Address - Street 1:1300 S BRYAN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6626
Mailing Address - Country:US
Mailing Address - Phone:956-271-4258
Mailing Address - Fax:956-583-2228
Practice Address - Street 1:1300 S BRYAN RD STE 101
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6688
Practice Address - Country:US
Practice Address - Phone:956-271-4258
Practice Address - Fax:956-583-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
TX276173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2131701OtherPK