Individual
DR. EILEEN M. O'BRIEN-SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
731 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092-6377
(817) 912-8800
(817) 912-8810
Mailing address
731 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092-6377
(817) 912-8800
(817) 912-8810
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J3363
TX
208000000X
Pediatrics Physician
Primary
J3363
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158265201
—
TX
01
—
8B5306
BCBS
TX
Enumeration date
07/28/2006
Last updated
06/11/2015
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