Healthcare Provider Details

I. General information

NPI: 1407278286
Provider Name (Legal Business Name): RRR HYPERBARICS 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 CHURCHILL DR STE 100
FLOWER MOUND TX
75022-2717
US

IV. Provider business mailing address

9151 BOULEVARD 26 STE 150B
NORTH RICHLAND HILLS TX
76180-5600
US

V. Phone/Fax

Practice location:
  • Phone: 817-337-6604
  • Fax:
Mailing address:
  • Phone: 682-683-2301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY LOCKHART
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 817-881-8571