Provider Demographics
NPI:1497282255
Name:MOBILE OCCUPATIONAL HEALTH AND WELLNESS URGENT CARE SOLUTIONS
Entity type:Organization
Organization Name:MOBILE OCCUPATIONAL HEALTH AND WELLNESS URGENT CARE SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:ENGSTRAND
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:817-344-9379
Mailing Address - Street 1:1723 CREEKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-3901
Mailing Address - Country:US
Mailing Address - Phone:817-344-9379
Mailing Address - Fax:
Practice Address - Street 1:5055 S 84TH ST
Practice Address - Street 2:
Practice Address - City:GREENDALE
Practice Address - State:WI
Practice Address - Zip Code:53129-1006
Practice Address - Country:US
Practice Address - Phone:817-344-9379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care