Healthcare Provider Details

I. General information

NPI: 1871974477
Provider Name (Legal Business Name): BROOKS TERREL D.V.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 SE 29TH ST
MIDWEST CITY OK
73110-8204
US

IV. Provider business mailing address

8701 SE 29TH ST
MIDWEST CITY OK
73110-8204
US

V. Phone/Fax

Practice location:
  • Phone: 405-732-0043
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number5519
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: