Healthcare Provider Details

I. General information

NPI: 1508009671
Provider Name (Legal Business Name): TERRY WAYNE HOLBROOK D.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2009
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 W WILL ROGERS BLVD
CLAREMORE OK
74017-5417
US

IV. Provider business mailing address

413 E 13TH ST
CLAREMORE OK
74017-6120
US

V. Phone/Fax

Practice location:
  • Phone: 918-341-1184
  • Fax: 918-341-6800
Mailing address:
  • Phone: 918-625-3392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13357
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: