Provider Demographics
NPI:1255922936
Name:ORNBERG, RICHARD W (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:ORNBERG
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6148 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3932
Mailing Address - Country:US
Mailing Address - Phone:214-519-4561
Mailing Address - Fax:
Practice Address - Street 1:4004 WORTH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1607
Practice Address - Country:US
Practice Address - Phone:214-623-6830
Practice Address - Fax:214-623-6807
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1028563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily