Provider Demographics
NPI:1316308802
Name:HEALTHY HEARTBEAT, PC
Entity type:Organization
Organization Name:HEALTHY HEARTBEAT, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:405-600-7361
Mailing Address - Street 1:1226 N SHARTEL AVE
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2421
Mailing Address - Country:US
Mailing Address - Phone:405-600-7361
Mailing Address - Fax:405-231-8884
Practice Address - Street 1:1226 N SHARTEL AVE
Practice Address - Street 2:SUITE 300B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2421
Practice Address - Country:US
Practice Address - Phone:405-600-7361
Practice Address - Fax:405-231-8884
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHY HEARTBEAT, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-11
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19336207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty