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General NPI Number Information
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NPI Number | 1699217703
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Entity Type | Organization
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Legal Business Name | CARENG CLINIC
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 1500 SW 44TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-4006
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Country | US
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Telephone | 405-615-3801
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 SW 44TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-4006
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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 | NURSE PRACTITIONER
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Name | MR. JOHNNY T NG
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Credential | NP
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Telephone | 405-615-3801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | R060453
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License Number State | OK
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