PROTOSTAR LLC (NPI# 1689138604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689138604 |
| Entity Type | Organization |
| Organization Name | PROTOSTAR LLC |
| Practice Address |
2080 N State Highway 360 Ste 230 Grand Prairie TX 75050-0900 |
| Practice Telephone | 6828881290 |
| Practice Fax Number | 9403127805 |
| Mailing Telephone | 2142894933 |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-23 |
| Authorized Official Name | RYAN KIPPES (CEO) |
| Authorized Official Telephone | 2142894933 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Servant's Heart Behavioral Health Clinic | Doing Business As Name - Organization |
| Street Address |
2080 N STATE HIGHWAY 360 STE 230 |
| City | GRAND PRAIRIE |
| State | TX |
| Zip Code | 75050-0900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225539695 | Christopher Bachman | Physical Therapy Assistant | 2045 Hwy 360, #100b, Grand Prarie, TX 75050 | 2018-02-21 |
| 1003335233 | L & B Group Home LLC | In Home Supportive Care | 605 E Palace Pkwy Ste, B4, Grand Prairie, TX 75050 | 2017-09-19 |
| 1073054748 | Smileeasy Dental Grand Prairie, Pllc | Dentist | 2650 S Hwy 161, Grand Prairie, TX 75050 | 2017-03-15 |
| 1164966651 | Prime Diagnostic Imaging of Irving, LLC | Clinic/Center | 2210 Paddock Way, Grand Prairie, TX 75050 | 2016-12-19 |
| 1366801037 | Monica Simpson | Counselor | 2080 N Hwy 360, Ste 430, Grand Prairie, TX 75050 | 2016-02-23 |
| 1437545845 | Stateserv Medical of Texas | Durable Medical Equipment & Medical Supplies | 1000 Post and Paddock Street, #305, Grand Prairie, TX 75050 | 2015-04-13 |
| 1912304593 | Tenishia Chintankwa | Non-emergency Medical Transport (VAN) | 2403 Doreen St, Grand Prairie, TX 75050 | 2014-11-26 |
| 1780023192 | Holland Surgical Group | Physician Assistant | 201 West Tarrant Rd. #1420, Grand Prairie, TX 75050 | 2013-06-19 |
| 1174962823 | Occumed Plus-grand Prairie | General Practice | 805 W. North Carrier Pkwy, 260, Grand Prairie, TX 75050 | 2013-06-17 |
| 1497099618 | Sorai Susanne S Stuart | Counselor | 2825 N. State Hwy 360, 710, Grand Prairie, TX 75050 | 2012-11-15 |
| Find all providers in zip 75050 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396226700 | Healthworks Med Group of Texas Darlington P A | Clinic/Center | 1700 N State Highway 360, Grand Prairie, TX 75050-1926 | 2018-08-23 |
| 1851803738 | Injury and Rehab Center | Clinic/Center | 200 N Carrier Pkwy Ste 101, Grand Prairie, TX 75050-5468 | 2017-10-31 |
| 1770931149 | Hotliveleads/mc33 | Clinic/Center | 1805 S Great Southwest Pkwy, 200, Grand Prairie, TX 75051-3502 | 2016-05-26 |
| 1235445123 | Trumed Family Clinic | Clinic/Center | 513 W Jefferson Blvd, Suite 170, Grand Prairie, TX 75051-1639 | 2010-08-30 |
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| 1174143002 | Ultimate Pain Solutions, P.l.l.c. | Clinic/Center | 9700 Richmond Ave Ste 120, Houston, TX 77042-4697 | 2020-04-21 |
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| Find all providers with the same taxonomy | ||||
| City | GRAND PRAIRIE |
| Zip Code | 75050 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.