Organization
STAR SOLACE MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIJU MATHEW MD (OWNER)
(602) 702-4660
Entity
Organization
Contact information
Practice address
5605 FM 423 STE 500-355, FRISCO, TX 75036-8960
(602) 702-4660
Mailing address
5605 FM 423 STE 500-355, FRISCO, TX 75036-8960
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700170867
INDIVIDUAL NPI
TX
Enumeration date
02/10/2023
Last updated
02/10/2023
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