Organization Active NPI

John C. O'Brien, Jr., MD, PA

  • Surgical Oncology Physician
  • Dallas, TX
National Provider Identifier
1104191667
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
D 6835 Issued in TX
Legal business name
JOHN C. O'BRIEN, JR., MD, PA
Practice address
8223 Forest Hills Blvd
Dallas, TX 75218-4410
Phone
(214) 320-9163
Fax
(214) 320-9163
NPI assigned
Mar 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John C. O'Brien Jr., MD
Title
President
Phone
(214) 320-9163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086X0206X D 6835 TX Primary

Addresses

Primary practice location

8223 Forest Hills Blvd
Dallas, TX 75218-4410

Mailing address

8223 Forest Hills Blvd
Dallas, TX 75218-4410
Phone (214) 320-9163

Other identifiers 1

IdentifierTypeStateIssuer
1134298-02MedicaidTX

National Provider Directory

National Provider Directory

Locations

1004 N Washington Ave
Dallas, TX 75204
Phone (214) 823-1550

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1104191667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8223 FOREST HILLS BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752184410",
            "telephone_number": "214-320-9163",
            "fax_number": "214-320-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8223 FOREST HILLS BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752184410",
            "telephone_number": "214-320-9163",
            "fax_number": "214-320-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. O'BRIEN, JR., MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-16",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-320-9163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "D 6835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134298-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.