Provider Demographics
NPI:1528599941
Name:DENTON OBSTETRICS AND GYNECOLOGY PA
Entity Type:Organization
Organization Name:DENTON OBSTETRICS AND GYNECOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-390-9585
Mailing Address - Street 1:209 N BONNIE BRAE ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3708
Mailing Address - Country:US
Mailing Address - Phone:817-573-9800
Mailing Address - Fax:817-573-9821
Practice Address - Street 1:209 N BONNIE BRAE ST
Practice Address - Street 2:SUITE 304
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3708
Practice Address - Country:US
Practice Address - Phone:817-573-9800
Practice Address - Fax:817-573-9821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6036207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty