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General NPI Number Information
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NPI Number | 1639566250
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Entity Type | Organization
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Legal Business Name | TEXAS OPTIMUM HEALTHCARE, LLC
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 2210 SAN JACINTO BLVD STE. 4
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City | DENTON
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State | TX
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Zip | 76205-7531
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Country | US
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Telephone | 940-387-3837
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Fax | 940-387-9924
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Provider Business Mailing Address
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Address Line | 2210 SAN JACINTO BLVD SUITE 4
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City | DENTON
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State | TX
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Zip | 76205-7531
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Country | US
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Telephone | 940-387-3837
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Fax | 940-387-9924
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Authorized Official
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Title or Position | OWNER
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Name | MR. BART STEELE
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Credential |
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Telephone | 940-387-3837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K2408
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA08941
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | P1368
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License Number State | TX
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