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General NPI Number Information
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NPI Number | 1699448191
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Entity Type | Individual
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Provider Name | ABBAS MALIK OD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2021
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 7021 S MEMORIAL DR STE 269
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City | TULSA
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State | OK
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Zip | 74133-2068
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Country | US
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Telephone | 918-984-9060
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Fax | 918-984-9068
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Provider Business Mailing Address
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Address Line | 1722 S CARSON AVE APT 1303
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City | TULSA
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State | OK
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Zip | 74119-4695
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Country | US
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Telephone | 859-553-3720
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3134
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License Number State | OK
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