Organization
FIVE STAR ER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL CONNER (CEO)
(512) 452-8533
Entity
Organization
Contact information
Practice address
8721 MANCHACA ROAD, AUSTIN, TX 78749
(512) 452-8533
(281) 209-8930
Mailing address
6300 LA CALMA DR, SUITE 200, AUSTIN, TX 78752-3843
(512) 452-8533
(281) 209-8930
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
160191
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH192E
BCBS
TX
Enumeration date
07/29/2015
Last updated
11/05/2015
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