Healthcare Provider Details

I. General information

NPI: 1134348758
Provider Name (Legal Business Name): S RENEE OBEY MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 W PARKER RD STE G22
PLANO TX
75093-8105
US

IV. Provider business mailing address

6300 W PARKER RD STE G22
PLANO TX
75093-8105
US

V. Phone/Fax

Practice location:
  • Phone: 972-981-7870
  • Fax: 972-981-7869
Mailing address:
  • Phone: 972-981-7870
  • Fax: 972-981-7869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberL9404
License Number StateTX

VIII. Authorized Official

Name: DR. SHAWANDA RENEE OBEY
Title or Position: OWNERPRESIDENT
Credential: M.D.
Phone: 972-981-7870