Healthcare Provider Details

I. General information

NPI: 1205488285
Provider Name (Legal Business Name): DANISH KHERANI MD, MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 S YALE AVE STE 209
TULSA OK
74136-8303
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 918-488-0990
  • Fax: 918-728-8036
Mailing address:
  • Phone: 888-247-0125
  • Fax: 918-502-8210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10068723
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number43258
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: