Healthcare Provider Details

I. General information

NPI: 1255914404
Provider Name (Legal Business Name): BRETT DAVID TRAXLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N LEE AVE
OKLAHOMA CITY OK
73102-1036
US

IV. Provider business mailing address

608 NW 9TH ST STE 6210
OKLAHOMA CITY OK
73102-1069
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-7000
  • Fax: 405-235-0738
Mailing address:
  • Phone: 405-272-9641
  • Fax: 405-235-0738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number8207
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: