Provider Demographics
NPI:1902215171
Name:FIRST CHOICE OCCUPATIONAL & WELLNESS LLC
Entity Type:Organization
Organization Name:FIRST CHOICE OCCUPATIONAL & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-661-1267
Mailing Address - Street 1:313 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4836
Mailing Address - Country:US
Mailing Address - Phone:361-661-1267
Mailing Address - Fax:361-661-1265
Practice Address - Street 1:313 E 1ST ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4836
Practice Address - Country:US
Practice Address - Phone:361-661-1267
Practice Address - Fax:361-661-1265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center