Healthcare Provider Details
I. General information
NPI: 1225774227
Provider Name (Legal Business Name): OPTIMUM POST ACUTE CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2022
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1501 E 19TH ST
EDMOND OK
73013-6618
US
IV. Provider business mailing address
PO BOX 737179
DALLAS TX
75373-7179
US
V. Phone/Fax
- Phone: 405-789-6359
- Fax: 405-359-5481
- Phone: 405-359-5370
- Fax: 405-359-5481
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MUHAMMAD
SANAULLAH
Title or Position: OWNER
Credential: MD
Phone: 405-789-6359