Healthcare Provider Details

I. General information

NPI: 1043663677
Provider Name (Legal Business Name): SHALYN HOOTEN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 N ROBINSON AVE
OKLAHOMA CITY OK
73102-5845
US

IV. Provider business mailing address

440 MERCHANT DR
NORMAN OK
73069-6470
US

V. Phone/Fax

Practice location:
  • Phone: 405-231-5800
  • Fax: 405-231-4200
Mailing address:
  • Phone: 405-809-8710
  • Fax: 405-573-6768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5125
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: