Healthcare Provider Details

I. General information

NPI: 1699554634
Provider Name (Legal Business Name): DAVID ROBERTS CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 NW 35TH ST
MOORE OK
73160-1027
US

IV. Provider business mailing address

PO BOX 7556
MOORE OK
73153-1556
US

V. Phone/Fax

Practice location:
  • Phone: 405-250-9973
  • Fax:
Mailing address:
  • Phone: 405-250-9973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DAVID E ROBERTS
Title or Position: CEO
Credential:
Phone: 405-250-9973