# PRO STAR MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528515988
- **Authorized official:** KIMBERLY NORRIS ELLIOTT (COO)
- **Authorized official phone:** (817) 996-5304

## Contact information

- **Practice address:** 4100 SPRING VALLEY, SUITE 642, DALLAS, TX 75244-3629
- **Practice address phone:** (888) 586-7764
- **Practice address fax:** (214) 279-9700
- **Mailing address:** 4100 SPRING VALLEY, SUITE 642, DALLAS, TX 75244-3629
- **Mailing address phone:** (888) 586-7764
- **Mailing address fax:** (214) 279-9700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 09/02/2016
- **Last updated:** 12/14/2016