Healthcare Provider Details

I. General information

NPI: 1285379784
Provider Name (Legal Business Name): SNAPSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 NW 23RD ST
OKLAHOMA CITY OK
73107-2406
US

IV. Provider business mailing address

10325 EASTLAKE DR
OKLAHOMA CITY OK
73162-6825
US

V. Phone/Fax

Practice location:
  • Phone: 405-525-3330
  • Fax:
Mailing address:
  • Phone: 405-816-6668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SOUZANA N ALKHOURI
Title or Position: MEMBER
Credential: MD
Phone: 405-816-6668