Provider Demographics
NPI:1821702556
Name:ESSENTIAL OCCUPATIONAL HEALTH AND SAFETY V, LLC
Entity Type:Organization
Organization Name:ESSENTIAL OCCUPATIONAL HEALTH AND SAFETY V, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:IBANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-334-0937
Mailing Address - Street 1:5424 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4635
Mailing Address - Country:US
Mailing Address - Phone:361-334-0937
Mailing Address - Fax:
Practice Address - Street 1:17581 OLD JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3930
Practice Address - Country:US
Practice Address - Phone:361-334-0937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty