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NPI Code Detail

MEDICARE: MELVYN PREISZ PH.D

MEDICARE: MELVYN PREISZ PH.D
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
1103TC0700XClinical Psychologist132OK

General Provider Information

NPI Number : 1386755148
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELVYN PREISZ PH.D
Provider Business Mailing Address
First Line : 3629 NW 51ST ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-5610
Country : US
Telephone Number : 405-601-0954
Fax Number : 405-601-3750
Provider Business Practice Location Address
First Line : 3629 NW 51ST ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-5610
Country : US
Telephone Number : 405-601-0954
Fax Number : 405-601-3750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 09/26/2011

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