Healthcare Provider Details
I. General information
NPI: 1912039009
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2007
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1959 S VAL VISTA ROAD SUITE 106
MESA AZ
85204
US
IV. Provider business mailing address
5080 SPECTRUM DRIVE SUITE 1200 WEST TOWER
ADDISON TX
75001
US
V. Phone/Fax
- Phone: 480-545-1398
- Fax: 480-545-1282
- Phone: 800-232-3550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
JOHN
ANDERSON
Title or Position: VP
Credential: DO
Phone: 972-364-8000