| Star Renal Care, Pllc | |
|
8668 John Hickman Pkwy Ste 1003 Frisco TX 75034 | |
| (214) 842-8743 | |
| (214) 556-1186 |
| Full Name | Star Renal Care, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8668 John Hickman Pkwy Ste 1003, Frisco, Texas |
| Authorized Official Name and Position | Fareha Abid Kazi (PRESIDENT) |
| Authorized Official Contact | 2149609846 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Renal Care, Pllc 8668 John Hickman Pkwy Ste 1003 Frisco TX 75034-9388 Ph: (469) 200-5764 | Star Renal Care, Pllc 8668 John Hickman Pkwy Ste 1003 Frisco TX 75034 Ph: (214) 842-8743 |
| NPI Number | 1679826895 |
|---|---|
| Provider Enumeration Date | 10/25/2012 |
| Last Update Date | 06/12/2018 |
| Medicare PECOS PAC ID | 5991023368 |
|---|---|
| Medicare Enrollment ID | O20150415000317 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679826895 | NPI | - | NPPES |
| 110C311580 | Other | TX | BCN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | P0985 (Texas) | Primary |
| Provider Name | Fareha Kazi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1598797060 PECOS PAC ID: 3072407733 Enrollment ID: I20120328000700 |
| Provider Name | Lawanda Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659874741 PECOS PAC ID: 5698025328 Enrollment ID: I20180830001055 |
| Provider Name | Anthony Amoako Addae |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962964791 PECOS PAC ID: 2860726148 Enrollment ID: I20190619002832 |
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