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General NPI Number Information
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NPI Number | 1154325850
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Entity Type | Organization
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Legal Business Name | OMEGA OB-GYN ASSOCIATES OF SOUTH ARLINGTON
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 3201 MATLOCK RD STE 350
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City | ARLINGTON
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State | TX
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Zip | 76015-2954
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Country | US
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Telephone | 817-468-3255
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Fax | 817-468-7823
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Provider Business Mailing Address
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Address Line | 3201 MATLOCK RD STE 350
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City | ARLINGTON
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State | TX
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Zip | 76015-2954
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Country | US
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Telephone | 817-468-3255
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Fax | 817-468-7823
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Authorized Official
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Title or Position | PARTNER
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Name | KEVIN R GORDON JR.
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Credential | M.D.
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Telephone | 817-468-3255
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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 |
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License Number State |
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