Healthcare Provider Details

I. General information

NPI: 1982665956
Provider Name (Legal Business Name): REBA BEARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MAGNOLIA CRT STE 102
MOORE OK
73160
US

IV. Provider business mailing address

1200 MAGNOLIA CRT STE 102
MOORE OK
73160
US

V. Phone/Fax

Practice location:
  • Phone: 405-793-9355
  • Fax: 855-538-3095
Mailing address:
  • Phone: 405-650-5470
  • Fax: 405-261-9266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number13557
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: