Individual
DIANA O'REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1325 PENNSYLVANIA AVE STE 680, FORT WORTH, TX 76104-2133
(817) 250-4235
Mailing address
1325 PENNSYLVANIA AVE STE 680, FORT WORTH, TX 76104-2133
(817) 250-4235
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA14895
TX
Other
Enumeration date
12/15/2017
Last updated
10/05/2021
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