Healthcare Provider Details

I. General information

NPI: 1528599941
Provider Name (Legal Business Name): DENTON OBSTETRICS AND GYNECOLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 PANHANDLE ST
DENTON TX
76201-2486
US

IV. Provider business mailing address

2510 PANHANDLE ST
DENTON TX
76201-2486
US

V. Phone/Fax

Practice location:
  • Phone: 940-503-3601
  • Fax: 940-503-3602
Mailing address:
  • Phone: 940-503-3601
  • Fax: 940-503-3602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberL6036
License Number StateTX

VIII. Authorized Official

Name: CHRISTINA ANN DOOLEY
Title or Position: OWNER
Credential: MD
Phone: 940-390-9585