Healthcare Provider Details

I. General information

NPI: 1437872249
Provider Name (Legal Business Name): SAMUEL STRECK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7711 E 111TH ST STE 111
TULSA OK
74133-2563
US

IV. Provider business mailing address

7711 E 111TH ST STE 111
TULSA OK
74133-2563
US

V. Phone/Fax

Practice location:
  • Phone: 918-928-5437
  • Fax: 888-720-8944
Mailing address:
  • Phone: 918-928-5437
  • Fax: 888-720-8944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9171
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: