Individual
CAROLYN STARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1905 LEARY LN, VICTORIA, TX 77901-2818
(361) 573-0731
(361) 576-4804
Mailing address
1905 LEARY LN, VICTORIA, TX 77901-2818
(361) 573-0731
(361) 576-4804
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1018901
TX
225X00000X
Occupational Therapist
101544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119587701
—
TX
05
—
119587707
—
TX
01
—
874T15
BC/BS #
TX
01
—
P01213010
RAILROAD MEDICARE
—
Enumeration date
01/11/2008
Last updated
10/30/2013
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