Individual ProviderCarolyn StarrPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1905 Leary Ln, Victoria, TX 77901-2818(361) 573-0731PECOS EnrollmentBased on the most recent information from CMS, provider Carolyn Starr does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1710163522Provider TypeIndividualFull NameStarr, CarolynCredentialOTGenderFemaleSole ProprietorNoEnumeration Date1/11/2008Last Updated10/30/2013Contact InformationPractice LocationPractice Address1905 Leary Ln, Victoria, TX 77901-2818Phone(361) 573-0731Fax(361) 576-4804Mailing LocationMailing Address1905 Leary Ln, Victoria, TX 77901-2818Phone(361) 573-0731Fax(361) 576-4804Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1018901TexasCode225X00000XDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense101544TexasProvider IdentifiersIDDescriptionIssuerIDP01213010DescriptionOtherIssuerRAILROAD MEDICAREID874T15DescriptionOtherIssuerBC/BS #TexasID874T15DescriptionOtherIssuerBC/BS PROVIDER #TexasID119587701DescriptionMedicaidIssuerUnlistedTexasID119587707DescriptionMedicaidIssuerUnlistedTexas