Provider Demographics
NPI:1508150228
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 CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
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:972-720-7906
Mailing Address - Street 1:5080 SPECTRUM DRIVE
Mailing Address - Street 2:SUITE 1200 WEST
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:811 NE ALSBURY
Practice Address - Street 2:SUITE 800
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028
Practice Address - Country:US
Practice Address - Phone:817-293-7311
Practice Address - Fax:817-551-1066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center