Provider Demographics
NPI:1417303025
Name:OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A.
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A.
Other - Org Name:CONCENTRA MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP, CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MPH
Authorized Official - Phone:972-720-7820
Mailing Address - Street 1:PO BOX 20127
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-0920
Mailing Address - Country:US
Mailing Address - Phone:972-720-7820
Mailing Address - Fax:214-775-4502
Practice Address - Street 1:5080 SPECTRUM DR
Practice Address - Street 2:STE 1200W
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4648
Practice Address - Country:US
Practice Address - Phone:972-720-7820
Practice Address - Fax:214-775-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service