Healthcare Provider Details

I. General information

NPI: 1417772625
Provider Name (Legal Business Name): TBI ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 NW 13TH ST
OKLAHOMA CITY OK
73106-6827
US

IV. Provider business mailing address

820 NW 13TH ST
OKLAHOMA CITY OK
73106-6827
US

V. Phone/Fax

Practice location:
  • Phone: 405-943-0303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0301X
TaxonomyBrain Injury Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: PATTY HOSKINS
Title or Position: MANAGER
Credential:
Phone: 405-206-2378