Provider Demographics
NPI:1154983831
Name:OBENG, ESMEY (PA)
Entity type:Individual
Prefix:
First Name:ESMEY
Middle Name:
Last Name:OBENG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ESMEY
Other - Middle Name:
Other - Last Name:OSABUTEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 ALMA DR STE 580
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7009
Mailing Address - Country:US
Mailing Address - Phone:469-344-1414
Mailing Address - Fax:469-863-7088
Practice Address - Street 1:1700 ALMA DR STE 580
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7009
Practice Address - Country:US
Practice Address - Phone:469-344-1414
Practice Address - Fax:469-863-7088
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13527363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty