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3421 Sw 104th St Ste 5 Oklahoma City OK 73159-7065 | |
(405) 237-3383 | |
(888) 440-2356 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3421 Sw 104th St Ste 5, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Ryan H. Bui (CEO) |
Authorized Official Contact | 4054143170 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3213 Sw 107th Ct Oklahoma City OK 73170-2561 Ph: (405) 414-3170 | 3421 Sw 104th St Ste 5 Oklahoma City OK 73159-7065 Ph: (405) 237-3383 |
NPI Number | 1720817786 |
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Provider Enumeration Date | 07/29/2024 |
Last Update Date | 09/27/2024 |
Medicare PECOS PAC ID | 4385183466 |
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Medicare Enrollment ID | O20240903004175 |
Identifier | Type | State | Issuer |
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1720817786 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Al Nguyen |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1295027647 PECOS PAC ID: 0446483986 Enrollment ID: I20140507001092 |
Provider Name | Ryan Hung Bui |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740955665 PECOS PAC ID: 7113322207 Enrollment ID: I20210827001787 |
Oklahoma Mental Health Council Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4420 N Lincoln Blvd, Oklahoma City, OK 73105 Phone: 405-424-7711 | |
American Current Care P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7100 S I-35 Service Road, Suite 7, Oklahoma City, OK 73149 Phone: 405-632-1002 Fax: 405-632-3131 | |
Oklahoma Pain & Rehab Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2149 Sw 59th St, Suite 201, Oklahoma City, OK 73119 Phone: 405-681-5800 | |
Board Of Regents Of The Univ Of Okla Ou Physicians Employer Spons Clin Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Robinson Ave, Suite 200, Oklahoma City, OK 73102 Phone: 405-271-8880 Fax: 405-208-8732 | |