Healthcare Provider Details

I. General information

NPI: 1023132297
Provider Name (Legal Business Name): NEURORESOURCES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 W MEMORIAL RD STE 7
OKLAHOMA CITY OK
73134-7000
US

IV. Provider business mailing address

PO BOX 14070
OKLAHOMA CITY OK
73113-0070
US

V. Phone/Fax

Practice location:
  • Phone: 405-286-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number883
License Number StateOK

VIII. Authorized Official

Name: WILLIAM D RUWE
Title or Position: OWNER
Credential: PHD
Phone: 405-286-6000