Healthcare Provider Details

I. General information

NPI: 1447470018
Provider Name (Legal Business Name): OBY'S MOBILE IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 INTERSTATE 30 STE G
MESQUITE TX
75150-2602
US

IV. Provider business mailing address

3201 INTERSTATE 30 STE G
MESQUITE TX
75150-2602
US

V. Phone/Fax

Practice location:
  • Phone: 972-613-7600
  • Fax: 972-613-7601
Mailing address:
  • Phone: 972-613-7600
  • Fax: 972-613-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. HUGHES A CHEATAM
Title or Position: DIRECTOR
Credential: MD
Phone: 972-613-7600