CENTENNIAL OB GYN PA NPI 1659354603

NPI Information

NPI: 1659354603
Provider Name: CENTENNIAL OB GYN PA
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 45D1037704

Address:
5757 WARREN PKWY
SUITE 210
FRISCO, TX
ZIP 75034
Phone: (972) 731-6565
Get Directions

CENTENNIAL OB GYN PA is an obstetrics gynecology in Frisco, TX. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. CENTENNIAL OB GYN PA NPI is 1659354603. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5757 WARREN PKWY
SUITE 210
FRISCO, TX
ZIP 75034-274
Phone: (972) 731-6565
Fax: (972) 731-6570

The provider's authorized official is Karen Kay Bausone .
The authorized official title is Practice Manager and has the following contact phone number (972) 731-6565.

The CLIA number assigned to this NPI record is 45D1037704 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/23/2005 and was last updated on 10/5/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207V00000X	Obstetrics & Gynecology				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00307X	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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