Provider Demographics
NPI:1851550370
Name:OCCUMED
Entity Type:Organization
Organization Name:OCCUMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDDLEBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-494-1419
Mailing Address - Street 1:2046 FOREST LN
Mailing Address - Street 2:SUITE 180
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7958
Mailing Address - Country:US
Mailing Address - Phone:972-494-1419
Mailing Address - Fax:972-494-2069
Practice Address - Street 1:2046 FOREST LN
Practice Address - Street 2:SUITE 180
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7958
Practice Address - Country:US
Practice Address - Phone:972-494-1419
Practice Address - Fax:972-494-2069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty