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General NPI Number Information
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NPI Number | 1588457006
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Entity Type | Organization
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Legal Business Name | JUSTIN JEFFREY OBANA, O.D. PLLC
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 818 N HIGHWAY 67 STE 104
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City | CEDAR HILL
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State | TX
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Zip | 75104-2150
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Country | US
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Telephone | 972-293-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 824 N BECKLEY AVE
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City | DALLAS
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State | TX
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Zip | 75203-1613
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Country | US
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Telephone | 214-714-8164
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JUSTIN OBANA
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Credential | OD
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Telephone | 972-293-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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