MEDICARE: TEXAS FAMILY AND OCCUPATIONAL HEALTH SERVICES I, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053352310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS FAMILY AND OCCUPATIONAL HEALTH SERVICES I, INC.

Provider Business Mailing Address
First Line	:	POB 810478
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75381-0478
Country	:	US
Telephone Number	:	214-572-8835
Fax Number	:	972-759-1518

Provider Business Practice Location Address
First Line	:	2300 VALLEY VIEW LN
Second Line	:	SUITE 100
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75234-5753
Country	:	US
Telephone Number	:	214-572-8835
Fax Number	:	972-759-1518

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFF A VITT
Credential	:
Telephone Number	:	214-572-8835

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	05/22/2008

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