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General NPI Number Information
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NPI Number | 1114141223
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Entity Type | Organization
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Legal Business Name | CHERIE H. O'BRIEN, M.D., P.A.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 1600 W COLLEGE ST SUITE 410
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City | GRAPEVINE
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State | TX
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Zip | 76051-3580
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Country | US
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Telephone | 817-329-4433
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Fax | 817-329-0190
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Provider Business Mailing Address
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Address Line | 1600 W COLLEGE ST SUITE 410
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City | GRAPEVINE
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State | TX
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Zip | 76051-3580
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Country | US
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Telephone | 817-329-4433
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Fax | 817-329-0190
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. DAVID J O'BRIEN
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Credential |
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Telephone | 817-329-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K6664
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License Number State | TX
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