Industrial Med Management of Haltom City, LLC

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

INDUSTRIAL MED MANAGEMENT OF HALTOM CITY, LLC

Practice address

3145 Denton Hwy
Haltom City, TX 76117-3710

Phone

(817) 831-0999

Fax

(817) 831-2228

NPI assigned

Oct 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sharla Gregg

Title

Credentialing Coordinator

Phone

(972) 991-9950

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1245429505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2486",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750012486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 DENTON HWY",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761173710",
            "telephone_number": "817-831-0999",
            "fax_number": "817-831-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDUSTRIAL MED MANAGEMENT OF HALTOM CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "GREGG",
        "authorized_official_first_name": "SHARLA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "972-991-9950"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "12345",
            "identifier": "12345",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel M Howe
• Rex Lynn Hulbert
• Paul Hung, DDS
• Shazia Hussain
• Ranhyok Im, PHARMD
• Melissa Lynn Inniss
• Innovative Medicare Solutions
• Integrated Federal Workers Center PLLC
• Christine B Jackson, S.L.P.
• Rita Michele Jackson

• Public Health & General Preventive Medicine Physician in Haltom City, TX
• Providers in Haltom City, TX by specialty
• Public Health & General Preventive Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.