Provider Demographics
NPI:1962482620
Name:GOLD STAR HEALTH SERVICES
Entity type:Organization
Organization Name:GOLD STAR HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-840-0000
Mailing Address - Street 1:7430 PRESTWICK CIR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-5437
Mailing Address - Country:US
Mailing Address - Phone:409-840-0000
Mailing Address - Fax:
Practice Address - Street 1:7430 PRESTWICK CIR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-5437
Practice Address - Country:US
Practice Address - Phone:409-840-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0696040001Medicare ID - Type Unspecified