Provider Demographics
NPI:1730164153
Name:BORDEN, STARR (MD)
Entity type:Individual
Prefix:
First Name:STARR
Middle Name:
Last Name:BORDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 SAN FELIPE ST
Mailing Address - Street 2:STE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2708
Mailing Address - Country:US
Mailing Address - Phone:713-972-8900
Mailing Address - Fax:888-876-4946
Practice Address - Street 1:6363 SAN FELIPE ST
Practice Address - Street 2:STE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-2708
Practice Address - Country:US
Practice Address - Phone:713-972-8900
Practice Address - Fax:888-876-4946
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1730164153Medicaid
TX0042QCOtherBCBS GROUP
TX8CS830OtherBCBS INDIVIDUAL
TX0042QCOtherBCBS GROUP
B21388Medicare UPIN
TX88Y401Medicare PIN