Healthcare Provider Details

I. General information

NPI: 1639172117
Provider Name (Legal Business Name): PAVEL RIHA MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 BROADWAY EXT STE 100
OKLAHOMA CITY OK
73116-8203
US

IV. Provider business mailing address

6500 BROADWAY EXT STE 100
OKLAHOMA CITY OK
73116-8203
US

V. Phone/Fax

Practice location:
  • Phone: 405-231-8882
  • Fax: 405-231-8884
Mailing address:
  • Phone: 405-231-8882
  • Fax: 405-231-8884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number19336
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: