Organization Name: | EXCEL OCCUPATIONAL CLINICS |
NPI Number: | 1003006818 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN R BENNETT (MEDICAL DIRECTOR) |
Mailing Address: | 6450 Brentwood Stair Rd Suite 110 Fort Worth |
State: | TX US |
Postal Code: | 761123239 |
Phone Number: | 8176540500 |
Fax Number: | |
NPI Enumeration Date: | 07/27/2007 |
NPI Last Update Date: | 07/27/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QX0100X |
License Number: | D1546 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Occupational Medicine |
Taxonomy Definition: |