Individual
BRENDAN DOMINIC OCONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 NORTHSHORE BLVD, PORTLAND, TX 78374
(361) 777-1777
Mailing address
PO BOX 1888, GREENVILLE, TX 75403
(800) 945-2455
(903) 453-2541
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J3864
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036852401
—
TX
Enumeration date
04/18/2006
Last updated
05/14/2008
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