| Complete & Comprehensive Kidney Care Pllc | |
|
810 Nw 10th St Ste A Oklahoma City OK 73106-7216 | |
| (405) 272-8367 | |
| Not Available |
| Full Name | Complete & Comprehensive Kidney Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 810 Nw 10th St Ste A, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Tariq A Khan (CEO) |
| Authorized Official Contact | 3146298948 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete & Comprehensive Kidney Care Pllc Po Box 268946 Oklahoma City OK 73126-8946 Ph: (405) 691-4703 | Complete & Comprehensive Kidney Care Pllc 810 Nw 10th St Ste A Oklahoma City OK 73106-7216 Ph: (405) 272-8367 |
| NPI Number | 1922647585 |
|---|---|
| Provider Enumeration Date | 12/31/2019 |
| Last Update Date | 12/31/2019 |
| Medicare PECOS PAC ID | 3375979263 |
|---|---|
| Medicare Enrollment ID | O20200213000917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922647585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | (* (Not Available)) | Primary |
| Provider Name | Tariq Asadullah Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396804662 PECOS PAC ID: 3870662182 Enrollment ID: I20181010000903 |
| Provider Name | Lauren D'ann Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821627167 PECOS PAC ID: 2668895178 Enrollment ID: I20200630003044 |
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