MEDICARE: OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP2000X	Physical Therapy Clinic/Center
2	261QX0100X	Occupational Medicine Clinic/Center
3	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1831604099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A.

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DRIVE
Second Line	:	SUITE 1200 WEST
City	:	ADDISON
State	:	TX
Zip	:	75001-4648
Country	:	US
Telephone Number	:	972-364-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 LAS VEGAS BLVD S TRLR C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-1932
Country	:	US
Telephone Number	:	702-676-6570
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ROBERT G HASSETT
Credential	:	DO MPH
Telephone Number	:	972-364-8000

Provider Enumeration Date	:	12/11/2017
Last Update Date	:	02/13/2018

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