Healthcare Provider Details

I. General information

NPI: 1538097050
Provider Name (Legal Business Name): BRETT MYRICK PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 SW 89TH ST
OKLAHOMA CITY OK
73139-9101
US

IV. Provider business mailing address

1225 SW 89TH ST
OKLAHOMA CITY OK
73139-9101
US

V. Phone/Fax

Practice location:
  • Phone: 405-616-0113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6848
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: