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General NPI Number Information
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NPI Number | 1881147650
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Entity Type | Organization
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Legal Business Name | GPA HEALTHWATCH CORPORATE CARE, INC.
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Dates
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Enumeration Date | 07/28/2016
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 12770 MERIT DR SUITE 200
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City | DALLAS
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State | TX
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Zip | 75251-1209
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Country | US
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Telephone | 972-744-2434
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Fax | 972-587-1417
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Provider Business Mailing Address
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Address Line | 12770 MERIT DR SUITE 200
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City | DALLAS
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State | TX
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Zip | 75251-1209
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Country | US
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Telephone | 972-744-2434
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Fax | 972-587-1417
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Authorized Official
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Title or Position | COO
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Name | MS. KATHY ENOCHS
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Credential | CSFS
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Telephone | 972-744-2445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 577403
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License Number State | TX
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