Provider Demographics
NPI:1114741774
Name:ANSARI, ZENAS SHAHIN
Entity type:Individual
Prefix:
First Name:ZENAS
Middle Name:SHAHIN
Last Name:ANSARI
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11601 W STANLEY DRAPER DR BLDG 1
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73165-6503
Mailing Address - Country:US
Mailing Address - Phone:405-799-7540
Mailing Address - Fax:405-735-2598
Practice Address - Street 1:11601 W STANLEY DRAPER DR BLDG 1
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73165-6503
Practice Address - Country:US
Practice Address - Phone:405-799-7540
Practice Address - Fax:405-735-2598
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist