Healthcare Provider Details
I. General information
NPI: 1336035260
Provider Name (Legal Business Name): VICTORIA SARAH BEDROS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1111 W 17TH ST
TULSA OK
74107-1886
US
IV. Provider business mailing address
2127 S LEWIS AVE
TULSA OK
74114-1455
US
V. Phone/Fax
- Phone: 785-250-3338
- Fax:
- Phone: 785-250-3338
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: