Healthcare Provider Details

I. General information

NPI: 1295685170
Provider Name (Legal Business Name): MAVERICK MEDICAL SERVICES, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10805 N MACARTHUR BLVD
OKLAHOMA CITY OK
73162-6901
US

IV. Provider business mailing address

4530 VARNA AVE
SHERMAN OAKS CA
91423-3128
US

V. Phone/Fax

Practice location:
  • Phone: 405-989-6237
  • Fax:
Mailing address:
  • Phone: 818-384-4350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. COURTNEY SEAN SCOTT
Title or Position: CEO, PRESIDENT
Credential:
Phone: 818-384-4350