Provider Demographics
NPI:1053091843
Name:OBS HOME BIRTH & WELLNESS PLLC
Entity type:Organization
Organization Name:OBS HOME BIRTH & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AME
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHENOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-703-7509
Mailing Address - Street 1:10345 ALTA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6501
Mailing Address - Country:US
Mailing Address - Phone:817-562-2828
Mailing Address - Fax:
Practice Address - Street 1:10345 ALTA VISTA RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6501
Practice Address - Country:US
Practice Address - Phone:817-562-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty