Healthcare Provider Details
I. General information
NPI: 1831400506
Provider Name (Legal Business Name): MONICA MAE MCLAREN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/28/2010
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
698 WESTSIDE DR STE 110
DURANT OK
74701-3085
US
IV. Provider business mailing address
5012 S US HWY 75, SUITE 300 ATTN BILLING
DENISON TX
75020-4589
US
V. Phone/Fax
- Phone: 580-920-1922
- Fax: 580-920-1923
- Phone: 580-920-1922
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 4972 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: