Provider Demographics
NPI:1902516446
Name:MSTARR ENTERPRISES LLC
Entity Type:Organization
Organization Name:MSTARR ENTERPRISES LLC
Other - Org Name:RENEW CLINICAL SCIENCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-800-0056
Mailing Address - Street 1:15531 DUNNS POND CT
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-3723
Mailing Address - Country:US
Mailing Address - Phone:817-800-0056
Mailing Address - Fax:
Practice Address - Street 1:6850 MANHATTAN BLVD STE 501
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-1227
Practice Address - Country:US
Practice Address - Phone:682-213-2214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MSTARR ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-23
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory