Healthcare Provider Details

I. General information

NPI: 1831995562
Provider Name (Legal Business Name): SYDNEY OBERHEIDEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W COLORADO BLVD
DALLAS TX
75208-2363
US

IV. Provider business mailing address

3420 ROSEDALE AVE APT 5
DALLAS TX
75205-1314
US

V. Phone/Fax

Practice location:
  • Phone: 214-947-8181
  • Fax:
Mailing address:
  • Phone: 214-300-8110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number1081919
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: