Healthcare Provider Details

I. General information

NPI: 1932174331
Provider Name (Legal Business Name): JULES L MERENDA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE PRICHARD D.O.

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 S 101ST EAST AVE STE 270
TULSA OK
74133
US

IV. Provider business mailing address

9001 S 101ST EAST AVE STE 270
TULSA OK
74133-5711
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-7000
  • Fax: 918-392-7013
Mailing address:
  • Phone: 918-392-7000
  • Fax: 918-392-7013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3814
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: