DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MRS. TERESA DESHAWN GREEN PHYSICIAN ASSISTANT

MEDICARE: MRS. TERESA DESHAWN GREEN PHYSICIAN ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantC5-0000491DE
2363A00000XPhysician AssistantPA031082DC
3363A00000XPhysician AssistantC0003136MD
4363A00000XPhysician Assistant2662OK

General Provider Information

NPI Number : 1295700425
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERESA DESHAWN GREEN PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 8422 N 123RD EAST AVE
Second Line :
City : OWASSO
State : OK
Zip : 74055-2130
Country : US
Telephone Number : 918-858-4353
Fax Number : 668-246-2942
Provider Business Practice Location Address
First Line : 1334 N LANSING AVE
Second Line :
City : TULSA
State : OK
Zip : 74106-5907
Country : US
Telephone Number : 918-587-2171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 03/19/2026

Similar Medicare Providers

1306468905 — ASHTEN RAY DUNCAN MD, MPH
Practice Location Address:
1334 N LANSING AVE
TULSA, OK
74106-5907
Practice Phone: 918-587-2171
Practice Fax:
1316948656 — MICHAEL T MONTAGUE PAC
Practice Location Address:
1334 N LANSING AVE
TULSA, OK
74106-5907
Practice Phone: 918-587-2171
Practice Fax: 918-295-6155
1285636829 — RUNAKO D WHITTAKER MD
Practice Location Address:
1334 N LANSING AVE
TULSA, OK
74106-5907
Practice Phone: 918-587-2171
Practice Fax: 918-295-6155
1841292331 — MS. CHARLENE FRANKLIN
Practice Location Address:
1334 N LANSING AVE
TULSA, OK
74106-5907
Practice Phone: 918-587-2171
Practice Fax: 918-295-6149
1275528085 — MORTON COMPREHENSIVE HEALTH SERVICES, INC
Practice Location Address:
1334 N LANSING AVE
TULSA, OK
74106-5907
Practice Phone: 918-587-2171
Practice Fax: 918-587-2171
1528053170 — DR. GAYLE A DENNEHY DDS
Practice Location Address:
1334 N LANSING AVE
TULSA, OK
74106-5907
Practice Phone: 918-295-6145
Practice Fax: 918-587-2173

Directions to “ MRS. TERESA DESHAWN GREEN PHYSICIAN ASSISTANT” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.