Healthcare Provider Details
I. General information
NPI: 1013387810
Provider Name (Legal Business Name): BDC MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2015
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13601 W MEMORIAL PARK DR STE 200
OKLAHOMA CITY OK
73120-8375
US
IV. Provider business mailing address
PO BOX 654470
DALLAS TX
75265-4470
US
V. Phone/Fax
- Phone: 405-751-0011
- Fax: 405-751-7246
- Phone: 405-751-0011
- Fax: 405-751-7246
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 4887 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | 4887 |
| License Number State | OK |
VIII. Authorized Official
Name:
BLAKE
DALBERT
CHRISTENSEN
Title or Position: OWNER
Credential: D.O.
Phone: 405-751-0011