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NPI Code Detail

MEDICARE: DR. STUART O'BRIEN R DDS, MS

MEDICARE:  DR. STUART O'BRIEN R  DDS, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0700XProsthodontics18148TX

General Provider Information

NPI Number : 1104847011
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STUART O'BRIEN R DDS, MS
Provider Business Mailing Address
First Line : 15958 CITY WALK
Second Line : STE 230
City : SUGAR LAND
State : TX
Zip : 77479-6583
Country : US
Telephone Number : 281-313-1565
Fax Number : 281-313-1575
Provider Business Practice Location Address
First Line : 15958 CITY WALK
Second Line : STE 230
City : SUGAR LAND
State : TX
Zip : 77479-6583
Country : US
Telephone Number : 281-313-1565
Fax Number : 281-313-1575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2006
Last Update Date : 07/08/2007

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