# SOS HEALTHCARE CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609004381
- **Authorized official:** MR. CHARLES C STIDHAM JR. (CEO)
- **Authorized official phone:** (817) 477-9494

## Contact information

- **Practice address:** 980 N WALNUT CREEK DR, SUITE 100, MANSFIELD, TX 76063-8019
- **Practice address phone:** (817) 477-5700
- **Practice address fax:** (817) 477-9122
- **Mailing address:** 304 E BROAD ST, MANSFIELD, TX 76063-1706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2009
- **Last updated:** 07/01/2009