Provider Demographics
NPI:1073284329
Name:OVERWATCH TECHNOLOGIES INC
Entity Type:Organization
Organization Name:OVERWATCH TECHNOLOGIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-449-2187
Mailing Address - Street 1:5906 FLINTSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5133
Mailing Address - Country:US
Mailing Address - Phone:214-449-2187
Mailing Address - Fax:
Practice Address - Street 1:5906 FLINTSHIRE LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5133
Practice Address - Country:US
Practice Address - Phone:214-449-2187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty