Provider Demographics
NPI:1033939863
Name:STAR ORTHOPEDICS AND SPORTS MEDICINE PLLC
Entity type:Organization
Organization Name:STAR ORTHOPEDICS AND SPORTS MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:DOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-850-0680
Mailing Address - Street 1:5550 WARREN PKWY STE 230
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7330
Mailing Address - Country:US
Mailing Address - Phone:972-616-4000
Mailing Address - Fax:972-294-3343
Practice Address - Street 1:149 E STATE HIGHWAY 121 STE 115
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7985
Practice Address - Country:US
Practice Address - Phone:469-850-0680
Practice Address - Fax:469-850-0681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty