Organization
PROFESSIONAL EMERGENCY SERVICE ASSOCIATION OF DESOTO
Active
Other names
EcCare Health Center of DeSoto
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY P. ENNIS M.D. (MEDICAL DIRECTOR)
(972) 659-1234
Entity
Organization
Contact information
Practice address
911 N HAMPTON RD, SUITE 120, DESOTO, TX 75115-3903
(972) 283-0444
(972) 283-4484
Mailing address
PO BOX 153068, IRVING, TX 75015-3068
(972) 659-1234
(972) 827-0195
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
10/28/2013
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