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General NPI Number Information
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NPI Number | 1306423017
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Entity Type | Individual
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Provider Name | JUSTIN MARSHALL O'BRIEN MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2021
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 4441 W AIRPORT FWY STE 215
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City | IRVING
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State | TX
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Zip | 75062-5959
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Country | US
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Telephone | 469-913-6136
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Fax |
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Provider Business Mailing Address
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Address Line | 4441 W AIRPORT FWY STE 215
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City | IRVING
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State | TX
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Zip | 75062-5959
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Country | US
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Telephone |
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | U3969
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License Number State | TX
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