Texas Star Bio Med Llc | |
4749 Fredericksburg Rd Ste A San Antonio TX 78229-4465 | |
(210) 997-8630 | |
(210) 733-1808 |
Full Name | Texas Star Bio Med Llc |
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Speciality | Clinical Medical Laboratory |
Location | 4749 Fredericksburg Rd Ste A, San Antonio, Texas |
Authorized Official Name and Position | Luke B Berry (OWNER) |
Authorized Official Contact | 2109978630 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Texas Star Bio Med Llc 4749 Fredericksburg Rd Ste A San Antonio TX 78229-4465 Ph: (210) 977-8630 | Texas Star Bio Med Llc 4749 Fredericksburg Rd Ste A San Antonio TX 78229-4465 Ph: (210) 997-8630 |
NPI Number | 1346915782 |
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Provider Enumeration Date | 08/09/2021 |
Last Update Date | 02/09/2023 |
Medicare PECOS PAC ID | 8527463462 |
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Medicare Enrollment ID | O20210816003121 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346915782 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Secondary |
291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Primary |
Provider Name | Amy Le |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1992149538 PECOS PAC ID: 3971876673 Enrollment ID: I20170831000725 |
Provider Name | Luke B Berry |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1568816692 PECOS PAC ID: 4082947049 Enrollment ID: I20190605002430 |
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