Provider Demographics
NPI:1699237800
Name:PRIME OCCUPATIONAL PHYSICIANS - TEXAS
Entity type:Organization
Organization Name:PRIME OCCUPATIONAL PHYSICIANS - TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:NABORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-240-7093
Mailing Address - Street 1:15481 AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-7314
Mailing Address - Country:US
Mailing Address - Phone:225-749-5750
Mailing Address - Fax:
Practice Address - Street 1:3749 HIGHWAY 69 N
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-1466
Practice Address - Country:US
Practice Address - Phone:409-209-2822
Practice Address - Fax:409-727-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine