Healthcare Provider Details

I. General information

NPI: 1033856273
Provider Name (Legal Business Name): NONI CHAU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 S YALE AVE STE 1200
TULSA OK
74136-8313
US

IV. Provider business mailing address

6600 S YALE AVE STE 1200
TULSA OK
74136-3333
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-3376
  • Fax: 918-502-3375
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4948
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: