Healthcare Provider Details

I. General information

NPI: 1376861971
Provider Name (Legal Business Name): MICHAEL SHAWN OBRIEN ACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 FANNIN ST SUITE 1101
HOUSTON TX
77030-2717
US

IV. Provider business mailing address

6550 FANNIN ST SUITE 1101
HOUSTON TX
77030-2717
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-0005
  • Fax:
Mailing address:
  • Phone: 713-441-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number708016
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: