Provider Demographics
NPI:1023106796
Name:JOHN A. OZO
Entity type:Organization
Organization Name:JOHN A. OZO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ANI
Authorized Official - Last Name:OZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-216-4894
Mailing Address - Street 1:702 BLACK CORAL DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-5436
Mailing Address - Country:US
Mailing Address - Phone:972-216-4894
Mailing Address - Fax:972-285-5185
Practice Address - Street 1:702 BLACK CORAL DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-5436
Practice Address - Country:US
Practice Address - Phone:972-216-4894
Practice Address - Fax:972-285-5185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009297251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457981Medicare Oscar/Certification