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General NPI Number Information
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NPI Number | 1407707110
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Entity Type | Organization
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Legal Business Name | BLISS FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 02/07/2026
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Last Update Date | 02/07/2026
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Provider Practice Location Address
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Address Line | 550 W 125TH PL S STE 300
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City | GLENPOOL
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State | OK
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Zip | 74033-5033
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Country | US
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Telephone | 918-640-4776
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Fax |
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Provider Business Mailing Address
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Address Line | 12704 S 4TH ST
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City | JENKS
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State | OK
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Zip | 74037-5089
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THERON BLISS
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Credential | DO
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Telephone | 918-640-4776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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