Healthcare Provider Details

I. General information

NPI: 1851035398
Provider Name (Legal Business Name): TASEL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9210 S WESTERN AVE STE A-21
OKLAHOMA CITY OK
73139-4982
US

IV. Provider business mailing address

3500 GRAND CANYON DR
NORMAN OK
73026-4700
US

V. Phone/Fax

Practice location:
  • Phone: 405-934-1681
  • Fax: 405-591-3148
Mailing address:
  • Phone: 405-934-1681
  • Fax: 405-591-3148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ERNEST T ABUNAW
Title or Position: OWNER
Credential: MD
Phone: 405-445-9266