Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | S5454 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | S5454 | TX |
NPI | 1013283860 |
---|---|
Provider Name | Adam O'brien |
First Address | Dallas, TX 75252-2450 |
Second Address | Dallas, TX 75252-2450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2012 |
Last Update Date | 17/06/2020 |