Dustin O'Hern, M.D.
Individual provider Active NPI Emergency Medicine Physician · Caddo, OK
NPI 1023367992 · NPPES record last updated Sep 6, 2012
Key facts
- NPI
- 1023367992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- P4359 (TX)
- Practice address
- 1152 S Cat City Rd
Caddo, OK 74729-5311 - Phone
- (918) 200-2274
- NPI assigned
- Sep 6, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130212000468 | TX | Practitioner - Emergency Medicine | 9830343219 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P4359 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine Services of TX, PLLC | Emergency Medicine | Current |
Accepting new patients |
| Rosebud Indian Health Service | Current |
Accepting new patients | |
| Rosebud Indian Health Service | Current |
Accepting new patients |
Locations
13725 Northwest Blvd
Corpus Christi, TX 78410
Phone (361) 241-4243
225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400
11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000
7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564
26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | P4359 | TX | Yes |
Addresses
Primary practice location
1152 S Cat City Rd
Caddo, OK 74729-5311
Mailing address
1152 S Cat City Rd
Caddo, OK 74729-5311
Phone (918) 200-2274
Other providers in Caddo, OK
- April Denise Hinkle
- Jill Love
- Janet Lee McBride
- Medicine Wheel Inc
- Medicine Wheel Inc
- Onesource LLC
- Alicia Pettett
All providers in Caddo, OK · Emergency Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.