Provider Demographics
NPI:1699448191
Name:MALIK, ABBAS (OD)
Entity type:Individual
Prefix:DR
First Name:ABBAS
Middle Name:
Last Name:MALIK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1722 S CARSON AVE APT 1303
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4695
Mailing Address - Country:US
Mailing Address - Phone:859-553-3720
Mailing Address - Fax:
Practice Address - Street 1:7021 S MEMORIAL DR STE 269
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-2068
Practice Address - Country:US
Practice Address - Phone:918-984-9060
Practice Address - Fax:918-984-9068
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3134152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist