Provider Demographics
NPI:1043411770
Name:COPPELL MINOR EMERGENCY CENTER P.A.
Entity Type:Organization
Organization Name:COPPELL MINOR EMERGENCY CENTER P.A.
Other - Org Name:CHARLES J. O'HEARN, M.D., P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-745-7601
Mailing Address - Street 1:270 N DENTON TAP RD STE 250
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2159
Mailing Address - Country:US
Mailing Address - Phone:972-745-7601
Mailing Address - Fax:972-745-7606
Practice Address - Street 1:270 N DENTON TAP RD STE 250
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2159
Practice Address - Country:US
Practice Address - Phone:972-745-7601
Practice Address - Fax:972-745-7606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care