# PROFESSIONAL EMERGENCY SERVICE ASSOCIATION OF DESOTO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EcCare Health Center of DeSoto
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114072550
- **Authorized official:** GREGORY P. ENNIS M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (972) 659-1234

## Contact information

- **Practice address:** 911 N HAMPTON RD, SUITE 120, DESOTO, TX 75115-3903
- **Practice address phone:** (972) 283-0444
- **Practice address fax:** (972) 283-4484
- **Mailing address:** PO BOX 153068, IRVING, TX 75015-3068
- **Mailing address phone:** (972) 659-1234
- **Mailing address fax:** (972) 827-0195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 10/28/2013