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General NPI Number Information
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NPI Number | 1508316530
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Entity Type | Individual
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Provider Name | SHAYNIEL STEARS P.A.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2016
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 16201 GOSSAMER WAY
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City | OKLAHOMA CITY
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State | OK
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Zip | 73165-1503
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Country | US
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Telephone | 208-709-2542
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Fax |
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Provider Business Mailing Address
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Address Line | 1705 E 19TH ST STE 302
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City | TULSA
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State | OK
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Zip | 74104-5410
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Country | US
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Telephone | 918-748-7585
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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