Provider Demographics
NPI:1568209252
Name:STARHOPE LIVER CENTER PA
Entity type:Organization
Organization Name:STARHOPE LIVER CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEMBRENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-833-4927
Mailing Address - Street 1:19179 BLANCO RD STE 105-249
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4042
Mailing Address - Country:US
Mailing Address - Phone:210-833-4927
Mailing Address - Fax:
Practice Address - Street 1:3303 ROGERS RD STE 230
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3688
Practice Address - Country:US
Practice Address - Phone:210-833-4927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant HepatologyGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatologyGroup - Multi-Specialty