| Mind Rejuvenation, Llc. | |
|
4922 E 73rd St Tulsa OK 74136-7007 | |
| (918) 392-4550 | |
| (918) 392-4551 |
| Full Name | Mind Rejuvenation, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4922 E 73rd St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Iftikhar Hussain (MEMBER) |
| Authorized Official Contact | 9183924550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Rejuvenation, Llc. 7307 S Yale Ave Ste 200 Tulsa OK 74136-7049 Ph: (918) 392-4550 | Mind Rejuvenation, Llc. 4922 E 73rd St Tulsa OK 74136-7007 Ph: (918) 392-4550 |
| NPI Number | 1811527518 |
|---|---|
| Provider Enumeration Date | 01/22/2020 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Medicare PECOS PAC ID | 9335593672 |
|---|---|
| Medicare Enrollment ID | O20230920003665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811527518 | NPI | - | NPPES |
| Provider Name | Cristina Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548934219 PECOS PAC ID: 0749678977 Enrollment ID: I20211020002997 |
| Provider Name | Kara Lynn Alger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104600279 PECOS PAC ID: 1456705086 Enrollment ID: I20230929001597 |
| Provider Name | Malik I Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770557985 PECOS PAC ID: 5294752648 Enrollment ID: I20240527000226 |
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