Provider Demographics
NPI:1326213414
Name:OB GYN ASSOCIATES OF DALLAS PLLC
Entity Type:Organization
Organization Name:OB GYN ASSOCIATES OF DALLAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BERTRAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-400-7284
Mailing Address - Street 1:5600 W LOVERS LN
Mailing Address - Street 2:SUITE 116-377
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-4330
Mailing Address - Country:US
Mailing Address - Phone:972-400-7284
Mailing Address - Fax:214-276-4345
Practice Address - Street 1:8305 WALNUT HILL LN
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4217
Practice Address - Country:US
Practice Address - Phone:214-363-5685
Practice Address - Fax:214-276-4345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty