Provider Demographics
NPI:1063143055
Name:DR ANGIE NAUMAN PLLC
Entity type:Organization
Organization Name:DR ANGIE NAUMAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:NAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-728-0876
Mailing Address - Street 1:12828 S MINGO RD
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-2149
Mailing Address - Country:US
Mailing Address - Phone:918-728-0878
Mailing Address - Fax:
Practice Address - Street 1:9118 S TOLEDO AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2700
Practice Address - Country:US
Practice Address - Phone:918-728-0876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental