Healthcare Provider Details

I. General information

NPI: 1306033758
Provider Name (Legal Business Name): HEALTHY HEARTBEAT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 N SHARTEL AVE SUITE 300
OKLAHOMA CITY OK
73103-2421
US

IV. Provider business mailing address

1226 N SHARTEL AVE SUITE 300
OKLAHOMA CITY OK
73103-2421
US

V. Phone/Fax

Practice location:
  • Phone: 405-231-8882
  • Fax: 405-231-8884
Mailing address:
  • Phone: 405-231-8882
  • Fax: 405-231-8884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number19336
License Number StateOK

VIII. Authorized Official

Name: PAVEL RIHA
Title or Position: PRESIDENT
Credential: M.D., PHD
Phone: 405-231-8882