Healthcare Provider Details

I. General information

NPI: 1740967629
Provider Name (Legal Business Name): FRANCIS MENDY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 S 101ST EAST AVE
TULSA OK
74133-5716
US

IV. Provider business mailing address

4 E 157TH ST S
GLENPOOL OK
74033-4434
US

V. Phone/Fax

Practice location:
  • Phone: 405-385-4419
  • Fax:
Mailing address:
  • Phone: 405-385-4419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number145668
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number122359
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: