Healthcare Provider Details

I. General information

NPI: 1285336479
Provider Name (Legal Business Name): OES OR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 N PORTLAND AVE
OKLAHOMA CITY OK
73112-2023
US

IV. Provider business mailing address

5600 N PORTLAND AVE
OKLAHOMA CITY OK
73112-2023
US

V. Phone/Fax

Practice location:
  • Phone: 405-943-4413
  • Fax:
Mailing address:
  • Phone: 405-943-4413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVEN SARKISIAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 405-943-4413