Active NPI
Timothy J O'Brien, M.D.
- Emergency Medicine Physician
- Conroe, TX
National Provider Identifier
1093785891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- K4515
- Practice address
- 504 Medical Center Blvd
Conroe, TX 77304-2808 - Phone
- (409) 539-1111
- Fax
- (409) 788-8044
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | K4515 | TX | Primary |
Addresses
Primary practice location
504 Medical Center Blvd
Conroe, TX 77304-2808
Mailing address
PO Box 200993
Houston, TX 77216-0993
Phone (281) 784-1111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8F9638 | Other | TX | BC/BS PROVIDER NUMBER |
| 1502445-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K4515 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greater Houston Emergency Physicians PLLC | Emergency Medicine | Past | Accepting new patients |
| Medical Center Emergency Physicians PA | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Dallas, TX
- NPI 1316363336
-
- Emergency Medicine Physician
- Houston, TX
- NPI 1639154230
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203033600000",
"number": "1093785891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 200993",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772160993",
"telephone_number": "281-784-1111",
"fax_number": "281-784-1555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 MEDICAL CENTER BLVD",
"city": "CONROE",
"state": "TX",
"postal_code": "773042808",
"telephone_number": "409-539-1111",
"fax_number": "409-788-8044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "TIMOTHY",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2008-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "K4515",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER NUMBER",
"identifier": "8F9638",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1502445-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.