Provider Demographics
NPI:1972052413
Name:QUALITY CARE HEALTH CLINICS OF NORTH TEXAS PLLC
Entity Type:Organization
Organization Name:QUALITY CARE HEALTH CLINICS OF NORTH TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:OSUJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-454-3637
Mailing Address - Street 1:465 WALES CT
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5140
Mailing Address - Country:US
Mailing Address - Phone:214-454-3637
Mailing Address - Fax:
Practice Address - Street 1:333 N SHILOH RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6680
Practice Address - Country:US
Practice Address - Phone:214-454-3637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6669207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2521Medicare UPIN