Healthcare Provider Details

I. General information

NPI: 1437975620
Provider Name (Legal Business Name): ANNA ELIZABETH PEREZ CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 STANTON L YOUNG BLVD
OKLAHOMA CITY OK
73104-5023
US

IV. Provider business mailing address

1121 SW 28TH ST
OKLAHOMA CITY OK
73109-2127
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8001
  • Fax: 405-271-1884
Mailing address:
  • Phone: 405-420-9327
  • Fax: 405-271-1884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number11558
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: