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General NPI Number Information
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NPI Number | 1528694676
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Entity Type | Organization
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Legal Business Name | TARU PLLC
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Dates
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Enumeration Date | 03/20/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 4801 INTEGRIS PKWY
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City | EDMOND
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State | OK
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Zip | 73034-8864
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Country | US
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Telephone | 405-757-9961
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Fax |
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Provider Business Mailing Address
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Address Line | 216 NW 151ST PL
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City | EDMOND
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State | OK
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Zip | 73013-1163
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Country | US
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Telephone | 405-757-9961
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAHA JAWAID KHAN
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Credential | MD
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Telephone | 405-757-9961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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