MEDICARE: PRECIOUS BANDELE

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
1	101Y00000X	Counselor		OK

General Provider Information

NPI Number	:	1407706815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRECIOUS BANDELE

Provider Business Mailing Address
First Line	:	203 W 26TH PL N
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74106-2205
Country	:	US
Telephone Number	:	918-841-6586
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 N GREENWOOD AVE STE 131
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74120-1444
Country	:	US
Telephone Number	:	918-559-7277
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ PRECIOUS BANDELE ” Practice Location

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