Healthcare Provider Details

I. General information

NPI: 1720111834
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: 03/14/2007
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 N STOUGHTON RD
MADISON WI
53704-2603
US

IV. Provider business mailing address

5080 SPECTRUM DR SUITE 1200 WEST
ADDISON TX
75001-4648
US

V. Phone/Fax

Practice location:
  • Phone: 608-244-1213
  • Fax: 214-775-4502
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth 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