# CENTENNIAL OB GYN PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659354603
- **Authorized official:** MRS. KAREN KAY BAUSONE (PRACTICE MANAGER)
- **Authorized official phone:** (972) 731-6565

## Contact information

- **Practice address:** 5757 WARREN PKWY, SUITE 210, FRISCO, TX 75034-4274
- **Practice address phone:** (972) 731-6565
- **Practice address fax:** (972) 731-6570
- **Mailing address:** 5757 WARREN PKWY, SUITE 210, FRISCO, TX 75034-4274
- **Mailing address phone:** (972) 731-6565
- **Mailing address fax:** (972) 731-6570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/23/2005
- **Last updated:** 10/05/2016