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General NPI Number Information
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NPI Number | 1285684019
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Entity Type | Organization
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Legal Business Name | CLEBURNE OB & GYN ASSOCIATES
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 505 N RIDGEWAY DR STE 160
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City | CLEBURNE
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State | TX
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Zip | 76033-5191
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Country | US
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Telephone | 817-774-2774
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Fax | 817-774-2776
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Provider Business Mailing Address
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Address Line | 505 N RIDGEWAY DR STE 160
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City | CLEBURNE
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State | TX
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Zip | 76033-5191
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Country | US
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Telephone | 817-774-2774
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Fax | 817-774-2776
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN A FARZAM
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Credential | MD
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Telephone | 817-774-2774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | J8438
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License Number State | TX
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