Provider Demographics
NPI:1215453949
Name:TOTAL EMBRACE OF OKLAHOMA, LLC
Entity type:Organization
Organization Name:TOTAL EMBRACE OF OKLAHOMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZEESHAAN
Authorized Official - Middle Name:IQBAL
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-973-0499
Mailing Address - Street 1:7600 S LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6836
Mailing Address - Country:US
Mailing Address - Phone:918-973-0499
Mailing Address - Fax:
Practice Address - Street 1:7600 S LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-6836
Practice Address - Country:US
Practice Address - Phone:918-973-0499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier