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General NPI Number Information
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NPI Number | 1164894499
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Entity Type | Organization
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Legal Business Name | ISTISHFA PLLC
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 15520 MONARCH LN
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City | EDMOND
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State | OK
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Zip | 73013-1134
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Country | US
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Telephone | 405-601-6181
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Fax | 405-601-7012
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Provider Business Mailing Address
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Address Line | 15520 MONARCH LN
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City | EDMOND
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State | OK
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Zip | 73013-1134
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Country | US
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Telephone | 405-601-6181
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Fax | 405-601-7012
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. BILALA PIRACHA
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Credential | M.D.
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Telephone | 405-601-6181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 29802
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 29802
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29802
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License Number State | OK
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