Healthcare Provider Details

I. General information

NPI: 1376452037
Provider Name (Legal Business Name): MRS. PAULINA OMOBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 E ABRAM ST STE 9
ARLINGTON TX
76010-1206
US

IV. Provider business mailing address

1141 WISHING WELL CT
CEDAR HILL TX
75104-8255
US

V. Phone/Fax

Practice location:
  • Phone: 817-987-1079
  • Fax: 817-422-0781
Mailing address:
  • Phone: 817-987-1079
  • Fax: 817-422-0781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number1246587
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: