Organization · Type 2 NPI
Protostar LLC
Multi-Specialty Clinic/Center · Grand Prairie, TX
NPI number
1689138604
Active
Practice location
2080 N State Highway 360 Ste 230
Grand Prairie, TX 75050-0900
Fax (940) 312-7805
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | None listed |
| Multi-Specialty Clinic/Center Primary | 261QM1300X | None listed |
Multi-Specialty Clinic/Center: Definition to come...
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About NPI 1689138604
Protostar LLC's National Provider Identifier is 1689138604, issued on Jan 23, 2019. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Grand Prairie, TX. The record was last updated on Jan 23, 2019.