Healthcare Provider Details

I. General information

NPI: 1770305211
Provider Name (Legal Business Name): LAO NEWTON ENTERPRISES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N RODEO DR
COMANCHE OK
73529-1426
US

IV. Provider business mailing address

275825 E 1840 RD
COMANCHE OK
73529-4046
US

V. Phone/Fax

Practice location:
  • Phone: 580-439-5848
  • Fax:
Mailing address:
  • Phone: 405-590-9462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEAH NEWTON
Title or Position: OWNER
Credential: APRN
Phone: 580-439-5848