Healthcare Provider Details
I. General information
NPI: 1962769869
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2012
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10345 PARKGLENN WAY
PARKER CO
80138-3883
US
IV. Provider business mailing address
5080 SPECTRUM DR SUITE 1200 WEST
ADDISON TX
75001-4648
US
V. Phone/Fax
- Phone: 972-364-8000
- Fax: 214-775-4502
- Phone: 972-364-8000
- Fax: 214-775-4502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
HASSETT
Title or Position: PRESIDENT
Credential: DO
Phone: 972-364-8000