Provider Demographics
NPI:1215163704
Name:BROTHERS & CROCHET OBGYN ASSOCIATES OF DALLAS LLP
Entity type:Organization
Organization Name:BROTHERS & CROCHET OBGYN ASSOCIATES OF DALLAS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:KANNADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-613-5379
Mailing Address - Street 1:411 N WASHINGTON AVE
Mailing Address - Street 2:STE 2700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:411 N WASHINGTON AVE
Practice Address - Street 2:STE 2700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:214-823-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2813008Medicaid
TX0029SUOtherBC/BS
TX2813008Medicaid