Healthcare Provider Details

I. General information

NPI: 1427511302
Provider Name (Legal Business Name): SAQIBA KHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 WASHINGTON DR STE 100
NORMAN OK
73069-1016
US

IV. Provider business mailing address

7904 S 92ND EAST PL
TULSA OK
74133-4952
US

V. Phone/Fax

Practice location:
  • Phone: 405-310-3735
  • Fax:
Mailing address:
  • Phone: 918-408-3654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: