Provider Demographics
NPI:1245621887
Name:CORE OCCUPATIONAL MEDICINE SERVICES
Entity type:Organization
Organization Name:CORE OCCUPATIONAL MEDICINE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-884-8100
Mailing Address - Street 1:126 W SAN AUGUSTINE ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-4024
Mailing Address - Country:US
Mailing Address - Phone:281-884-8100
Mailing Address - Fax:832-324-4060
Practice Address - Street 1:126 W SAN AUGUSTINE ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-4024
Practice Address - Country:US
Practice Address - Phone:281-884-8100
Practice Address - Fax:832-324-4060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX669983363LX0106X
TXN6352364SX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SX0106XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOccupational HealthGroup - Multi-Specialty
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Multi-Specialty