MEDICARE: PEACE OF MIND PEDIATRICS PLLC

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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1467039669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND PEDIATRICS PLLC

Provider Business Mailing Address
First Line	:	5476 MAIN ST STE 104
Second Line	:
City	:	DEL CITY
State	:	OK
Zip	:	73115-5523
Country	:	US
Telephone Number	:	405-602-5166
Fax Number	:

Provider Business Practice Location Address
First Line	:	7804 NW 89TH ST STE 2
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-3213
Country	:	US
Telephone Number	:	405-602-5166
Fax Number	:

Authorized Official
Title or Position	:	OWNER, LEAD PHYSICIAN
Name	:	NOOR JIHAN ABDUL-HAQQ
Credential	:	MD
Telephone Number	:	405-602-5166

Provider Enumeration Date	:	03/25/2021
Last Update Date	:	03/25/2021

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Directions to “PEACE OF MIND PEDIATRICS PLLC ” Practice Location

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