Healthcare Provider Details

I. General information

NPI: 1710574900
Provider Name (Legal Business Name): SENNA SOUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NE 13TH ST
OKLAHOMA CITY OK
73104-5004
US

IV. Provider business mailing address

1100 N LINDSAY AVE
OKLAHOMA CITY OK
73104-5410
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6651
  • Fax: 405-271-1476
Mailing address:
  • Phone: 405-271-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number39521
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: