| Wound Integrity Oklahoma Pa | |
|
1120 S Utica Ave Tulsa OK 74104-4012 | |
| (512) 202-3830 | |
| (512) 354-1106 |
| Full Name | Wound Integrity Oklahoma Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1120 S Utica Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Han Pham Hulen (OWNER) |
| Authorized Official Contact | 2142741507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wound Integrity Oklahoma Pa Po Box 3409 Pflugerville TX 78691-3409 Ph: (512) 202-3830 | Wound Integrity Oklahoma Pa 1120 S Utica Ave Tulsa OK 74104-4012 Ph: (512) 202-3830 |
| NPI Number | 1689289910 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 09/14/2020 |
| Medicare PECOS PAC ID | 0345626990 |
|---|---|
| Medicare Enrollment ID | O20221005000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689289910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Han Pham Hulen |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1770593436 PECOS PAC ID: 7719923101 Enrollment ID: I20221005000221 |
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