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General NPI Number Information
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NPI Number | 1164887410
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Entity Type | Individual
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Provider Name | LAWRENCE OBI
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Gender | Male
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 7115 S MASON RD # 1911
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City | RICHMOND
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State | TX
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Zip | 77407-4474
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Country | US
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Telephone | 248-794-5065
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Fax | 832-945-2192
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Provider Business Mailing Address
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Address Line | 7115 S MASON RD # 1911
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City | RICHMOND
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State | TX
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Zip | 77407-4474
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Country | US
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Telephone | 248-794-5065
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Fax | 832-945-2192
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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