Healthcare Provider Details

I. General information

NPI: 1487215786
Provider Name (Legal Business Name): ASRA TANWIR M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST STE 5B
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

711 STANTON L YOUNG BLVD STE 209
OKLAHOMA CITY OK
73104-5021
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-3635
  • Fax: 405-271-2523
Mailing address:
  • Phone: 405-271-4113
  • Fax: 405-271-5723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number73713
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number44604
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number73713
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number44604
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: