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General NPI Number Information
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NPI Number | 1871658435
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Entity Type | Organization
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Legal Business Name | OHTC HEALTH CARE SYSTEM, PLLC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 2625 OLD DENTON RD SUITE 546
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City | CARROLLTON
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State | TX
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Zip | 75007-5125
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Country | US
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Telephone | 972-608-8877
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Fax | 972-245-8888
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Provider Business Mailing Address
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Address Line | 2625 OLD DENTON RD SUITE 546
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City | CARROLLTON
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State | TX
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Zip | 75007-5125
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Country | US
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Telephone | 972-608-8877
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Fax | 972-245-8888
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. EDWARD SONG
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Credential | L.AC., PH.D
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Telephone | 972-608-8877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | AC00007
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License Number State | TX
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