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General NPI Number Information
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NPI Number | 1942242680
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Entity Type | Organization
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Legal Business Name | 1ST TOTAL HEALTH CARE
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 09/26/2012
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Provider Practice Location Address
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Address Line | 3333 KNOLLCREST LN
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City | MESQUITE
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State | TX
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Zip | 75181-2938
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Country | US
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Telephone | 469-831-1960
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Fax | 972-222-6658
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Provider Business Mailing Address
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Address Line | 3333 KNOLLCREST LN
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City | MESQUITE
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State | TX
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Zip | 75181-2938
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Country | US
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Telephone | 469-831-1960
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Fax | 972-222-6658
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PETER EBERE
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Credential |
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Telephone | 469-831-1960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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