Provider Demographics
NPI:1649076340
Name:OASISROCK MEDICAL CENTRE PLLC
Entity type:Organization
Organization Name:OASISROCK MEDICAL CENTRE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBERECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ANOZIE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-687-5349
Mailing Address - Street 1:1919 CADDO VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-8456
Mailing Address - Country:US
Mailing Address - Phone:973-687-5349
Mailing Address - Fax:
Practice Address - Street 1:905 MEDICAL CENTRE DR STE C
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4755
Practice Address - Country:US
Practice Address - Phone:973-687-5349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty