Provider Demographics
NPI:1154716256
Name:OBAGI, AREF (MD)
Entity type:Individual
Prefix:
First Name:AREF
Middle Name:
Last Name:OBAGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 W RANDOL MILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2581
Mailing Address - Country:US
Mailing Address - Phone:817-461-3003
Mailing Address - Fax:
Practice Address - Street 1:902 W RANDOL MILL RD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2581
Practice Address - Country:US
Practice Address - Phone:817-461-3003
Practice Address - Fax:844-290-4365
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4567207UN0901X, 207RI0011X, 207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease