Healthcare Provider Details

I. General information

NPI: 1528106614
Provider Name (Legal Business Name): TESSA LYNN CHESHER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TESSA LYNN SALAZAR

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 E 31ST ST FL LL
TULSA OK
74135-5018
US

IV. Provider business mailing address

5310 E 31ST ST FL 13
TULSA OK
74135-5018
US

V. Phone/Fax

Practice location:
  • Phone: 918-236-4000
  • Fax: 918-236-4001
Mailing address:
  • Phone: 918-561-5701
  • Fax: 918-561-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4392
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4392
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: