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General NPI Number Information
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NPI Number | 1801052980
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTH PA
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 2741 E BELT LINE RD SUITE 101
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City | CARROLLTON
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State | TX
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Zip | 75006-5445
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Country | US
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Telephone | 972-416-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 2741 E BELT LINE RD SUITE 101
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City | CARROLLTON
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State | TX
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Zip | 75006-5445
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CALVIN H NGUYEN
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Credential | D.C.
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Telephone | 972-416-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 10720
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 10720
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10720
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 10720
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License Number State | TX
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