Organization
BLUE STAR REHABILITATION PLANO LLC
Active
Other names
Blue Star Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS PAUL GREEN (OWNER)
(972) 445-4134
Entity
Organization
Contact information
Practice address
17754 PRESTON RD STE 100, DALLAS, TX 75252-5638
(972) 476-9036
(972) 476-9926
Mailing address
800 W AIRPORT FWY # 959, IRVING, TX 75062-6312
(972) 445-4134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588051114
ADDITIONAL ORGANIZATION NPI
TX
Enumeration date
04/09/2020
Last updated
10/02/2023
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