Healthcare Provider Details

I. General information

NPI: 1962605444
Provider Name (Legal Business Name): RICHARD BART STEEN HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6803 E RENO AVE
MIDWEST CITY OK
73110-2167
US

IV. Provider business mailing address

1535 SUNWAY
OKLAHOMA CITY OK
73127-7020
US

V. Phone/Fax

Practice location:
  • Phone: 405-733-8286
  • Fax: 405-732-9765
Mailing address:
  • Phone: 405-733-8286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number951
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: