Provider Demographics
NPI:1144431644
Name:OGG, KRISTEN M (DO)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:M
Last Name:OGG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4000 SIGMA RD APT 1404
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-8116
Mailing Address - Country:US
Mailing Address - Phone:216-233-3021
Mailing Address - Fax:
Practice Address - Street 1:4821 MERLOT AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:972-867-3627
Practice Address - Fax:817-421-7560
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0326207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208212501Medicaid
TX8L21063Medicare PIN