Healthcare Provider Details
I. General information
NPI: 1548657885
Provider Name (Legal Business Name): OHC OF THE SOUTHWEST P.A. P.S.C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2015
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 S 1ST ST
LOUISVILLE KY
40202-1416
US
IV. Provider business mailing address
5080 SPECTRUM DR STE 1200W
ADDISON TX
75001-4624
US
V. Phone/Fax
- Phone: 502-574-2292
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
G
HASSETT
Title or Position: VP
Credential:
Phone: 972-364-8000