Olive Branch Medical Associates PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OLIVE BRANCH MEDICAL ASSOCIATES PLLC

Practice address

1270 County Road 4755
Warren, TX 77664-7714

Phone

(409) 651-5423

NPI assigned

Mar 31, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Teresa Brown, BSN, RN

Title

Administrator

Phone

(409) 651-5423

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1770111072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 COUNTY ROAD 4755",
            "city": "WARREN",
            "state": "TX",
            "postal_code": "776647714",
            "telephone_number": "409-651-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 COUNTY ROAD 4755",
            "city": "WARREN",
            "state": "TX",
            "postal_code": "776647714",
            "telephone_number": "409-651-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "409-651-5423",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Deeann Adams, LAT
• Patricia Ann Bryan Evans, MS, CCC/SLP
• Tammy Dorraine Hays, M.A.
• Samantha McCormick
• Starla Gail McIntosh, MS, RD, LD
• Julia Nicole Sanderson
• Melanie J Shepherd
• Amber Thompson
• Laura Vann
• Warren Isd

• All providers in Warren, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.