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General NPI Number Information
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NPI Number | 1629472998
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Entity Type | Organization
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Legal Business Name | OKLAHOMA STATE DEPARTMENT OF HEALTH
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 1010 SW SHERIDAN RD
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City | LAWTON
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State | OK
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Zip | 73505-1531
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Country | US
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Telephone | 580-248-5890
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 NE 10TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-1207
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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 | APRN
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Name | BRIANNA MARIE VARGAS
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Credential |
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Telephone | 580-649-5064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number | R0099778
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License Number State | OK
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