Provider Demographics
NPI:1699287094
Name:DENNIS D OBANION MD
Entity type:Organization
Organization Name:DENNIS D OBANION MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEAHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-614-5355
Mailing Address - Street 1:2604 SAINT MICHAEL DR STE 239
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2378
Mailing Address - Country:US
Mailing Address - Phone:903-614-5355
Mailing Address - Fax:903-614-5399
Practice Address - Street 1:1801 GALLERIA OAKS DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4616
Practice Address - Country:US
Practice Address - Phone:903-614-4200
Practice Address - Fax:903-614-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center