Provider Demographics
NPI:1275629560
Name:MEDALERT OCCUPATIONAL MANAGEMENT INC.
Entity Type:Organization
Organization Name:MEDALERT OCCUPATIONAL MANAGEMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:GUILLERMO
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MRO
Authorized Official - Phone:214-630-1144
Mailing Address - Street 1:3141 IRVING BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-6232
Mailing Address - Country:US
Mailing Address - Phone:214-630-1144
Mailing Address - Fax:214-631-6815
Practice Address - Street 1:3141 IRVING BLVD
Practice Address - Street 2:STE 220
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-6232
Practice Address - Country:US
Practice Address - Phone:214-630-1144
Practice Address - Fax:214-631-6815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8873261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE64938Medicare UPIN