Spectra Medical Home Mht LLC
Physician Assistant in Choctaw, OK. Organization (NPI-2).
NPI number1700201498
StatusActive
Last updated in NPPESMar 4, 2014
Details
- NPI
- 1700201498
- Entity type
- Organization (NPI-2)
- Legal business name
- Spectra Medical Home Mht LLC
- Organization subpart
- No
- Enumeration date
- Mar 4, 2014
- Last updated
- Mar 4, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | pa619 | OK | Yes |
Practice location
12500 Ne 36th StChoctaw, OK 73020-9111
Phone 855-860-2109
Mailing address
1515 Heritage DriveSuite 110
McKinney, TX 75069-3379
Phone 972-616-4702
Authorized official
Elmer Gari Owens
Owner
8558602109
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Other Physician Assistant providers in Choctaw, OK
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- Chelsea WaldropNPI 1174235832
All 5 Physician Assistant providers in Choctaw · All 265 providers in Choctaw
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