Provider Demographics
NPI: | 1073790952 |
---|---|
Name: | TOTAL HEALTHCARE MANAGEMENT |
Entity type: | Organization |
Organization Name: | TOTAL HEALTHCARE MANAGEMENT |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | TOCHI |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | OSUJI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 214-454-3637 |
Mailing Address - Street 1: | PO BOX 2827 |
Mailing Address - Street 2: | |
Mailing Address - City: | COPPELL |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75019-8827 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-230-0333 |
Mailing Address - Fax: | 972-230-8810 |
Practice Address - Street 1: | 2700 W PLEASANT RUN RD |
Practice Address - Street 2: | SUITE 200 |
Practice Address - City: | LANCASTER |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75146-1079 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-230-0333 |
Practice Address - Fax: | 972-230-8810 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-01-23 |
Last Update Date: | 2008-01-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 17674674 | 171W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 171W00000X | Other Service Providers | Contractor | Group - Multi-Specialty |