Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | Q4659 | TX |
Y | 207QS0010X | Family Doctor - Sports Medicine | Q4659 | TX |
NPI | 1033136908 |
---|---|
Provider Name | Brandon Christopher Ohman |
First Address | Wichita Falls, TX 76308-9261 |
Second Address | Wichita Falls, TX 76310-2303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 13/10/2020 |