Healthcare Provider Details

I. General information

NPI: 1255863395
Provider Name (Legal Business Name): LAUREN DEANNA THOMAS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 S HOUSTON AVE SUITE 200
TULSA OK
74127-9023
US

IV. Provider business mailing address

717 S. HOUSTON AVE. SUITE 200
TULSA OK
74127-9005
US

V. Phone/Fax

Practice location:
  • Phone: 918-586-4522
  • Fax: 918-568-4531
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number6379
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: