MEDICARE: OCCUPATIONAL HEALTH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LX0106X	Occupational Health Nurse Practitioner	745060	TX

General Provider Information

NPI Number	:	1285954883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	130 S CENTRAL EXPY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-3742
Country	:	US
Telephone Number	:	972-548-5356
Fax Number	:	972-548-5357

Provider Business Practice Location Address
First Line	:	130 S CENTRAL EXPY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-3742
Country	:	US
Telephone Number	:	972-548-5356
Fax Number	:	972-548-5357

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. TORI OWENS
Credential	:	MSN
Telephone Number	:	972-548-5392

Provider Enumeration Date	:	06/04/2010
Last Update Date	:	06/04/2010

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Directions to “OCCUPATIONAL HEALTH CENTER ” Practice Location

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