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General NPI Number Information
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NPI Number | 1952718140
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Entity Type | Organization
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Legal Business Name | MUDASSIR NAWAZ M.D. CLINIC
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Dates
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Enumeration Date | 07/19/2014
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Last Update Date | 07/19/2014
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Provider Practice Location Address
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Address Line | 500 E ROBINSON ST SUITE 800
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City | NORMAN
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State | OK
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Zip | 73071-6697
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Country | US
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Telephone | 405-321-1004
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Fax | 405-321-1074
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Provider Business Mailing Address
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Address Line | 500 E ROBINSON ST SUITE 800
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City | NORMAN
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State | OK
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Zip | 73071-6697
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Country | US
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Telephone | 405-321-1004
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Fax | 405-321-1074
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | TERRI HERRIAN
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Credential | NP
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Telephone | 405-321-1004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 79034
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License Number State | OK
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