Provider Demographics
NPI:1225097934
Name:DENNIS OCHEI MD, PA
Entity Type:Organization
Organization Name:DENNIS OCHEI MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:O
Authorized Official - Last Name:OCHEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-206-2630
Mailing Address - Street 1:2707 BOLTON BOONE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2077
Mailing Address - Country:US
Mailing Address - Phone:469-206-2630
Mailing Address - Fax:214-730-4281
Practice Address - Street 1:2707 BOLTON BOONE DR STE 100
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2077
Practice Address - Country:US
Practice Address - Phone:469-206-2630
Practice Address - Fax:214-730-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005MG/8R7201OtherBCBS
TX1631996-01Medicaid
TX1631996-01Medicaid
=========OtherEIN
TX1631996-01Medicaid