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NPI Code Detail

MEDICARE: COUNCIL OAK COMPREHENSIVE HEALTH

MEDICARE: COUNCIL OAK COMPREHENSIVE HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1699624882
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNCIL OAK COMPREHENSIVE HEALTH
Provider Business Mailing Address
First Line : 10109 E 79TH ST
Second Line :
City : TULSA
State : OK
Zip : 74133-4682
Country : US
Telephone Number : 918-940-7543
Fax Number :
Provider Business Practice Location Address
First Line : 10109 E 79TH ST
Second Line :
City : TULSA
State : OK
Zip : 74133-4682
Country : US
Telephone Number : 918-940-7543
Fax Number :
Authorized Official
Title or Position : SECRETARY OF HEALTH
Name : SHAWN TERRY
Credential :
Telephone Number : 918-233-9550
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “COUNCIL OAK COMPREHENSIVE HEALTH ” Practice Location

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