Healthcare Provider Details

I. General information

NPI: 1992995146
Provider Name (Legal Business Name): ZAINAL M. HUSSAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 S UTICA AVE FL 4
TULSA OK
74104-6520
US

IV. Provider business mailing address

1923 S UTICA AVE FL 4
TULSA OK
74104-6520
US

V. Phone/Fax

Practice location:
  • Phone: 918-748-7650
  • Fax: 918-403-6341
Mailing address:
  • Phone: 918-748-7650
  • Fax: 918-403-6341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number33374
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: