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Individual

LANCE G OBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
7300 BOSQUE BLVD., WACO, TX 76710
(254) 202-2600
(254) 202-2650
Mailing address
PO BOX 848476, DALLAS, TX 75284-8476
(254) 202-4655
(254) 202-4697

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E7212
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00F72F
BLUE CROSS BLUE SHIELD
TX
05
098299301
TX
Enumeration date
08/09/2006
Last updated
01/07/2021
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