Provider Demographics
NPI:1598568701
Name:OBRZUT, ADELINE
Entity type:Individual
Prefix:
First Name:ADELINE
Middle Name:
Last Name:OBRZUT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ADELINE
Other - Middle Name:
Other - Last Name:BORSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1316 HUCKLEBERRY ST
Mailing Address - Street 2:
Mailing Address - City:NORTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-3274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1790 KING ARTHUR BLVD STE 120
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-2040
Practice Address - Country:US
Practice Address - Phone:972-984-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81783231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist