Healthcare Provider Details

I. General information

NPI: 1003823592
Provider Name (Legal Business Name): CHRIS A GENTRY PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 NE 13TH ST VA MEDICAL CENTER, PHARMACY SVC (119)
OKLAHOMA CITY OK
73104-5007
US

IV. Provider business mailing address

2913 SLOANE ST
NORMAN OK
73072-2290
US

V. Phone/Fax

Practice location:
  • Phone: 405-270-1549
  • Fax: 405-297-5934
Mailing address:
  • Phone: 405-270-1549
  • Fax: 405-297-5934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: