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General NPI Number Information
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NPI Number | 1407485469
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Entity Type | Individual
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Provider Name | BROOKS DANIEL WALKER MD
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Gender | Male
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 3840 S BOULEVARD STE 101
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City | EDMOND
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State | OK
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Zip | 73013-5888
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Country | US
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Telephone | 405-471-5252
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Fax | 405-726-8530
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Provider Business Mailing Address
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Address Line | 1455 S DOUGLAS BLVD STE D
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City | MIDWEST CITY
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State | OK
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Zip | 73130-5269
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Country | US
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Telephone | 636-227-2600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 43503
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License Number State | OK
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