Healthcare Provider Details

I. General information

NPI: 1821058249
Provider Name (Legal Business Name): LINH THAI MOKHTEE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINH THAI

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6585 S YALE AVE STE 650
TULSA OK
74136-8319
US

IV. Provider business mailing address

6600 S YALE AVE STE 1400
TULSA OK
74136-3331
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-5600
  • Fax: 918-502-5603
Mailing address:
  • Phone: 918-499-4855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA04015
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4694
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: