Provider Demographics
NPI:1962101451
Name:QUAIL BROOK FAMILY MEDICAL & URGENT CARE
Entity type:Organization
Organization Name:QUAIL BROOK FAMILY MEDICAL & URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:QUY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-916-9265
Mailing Address - Street 1:4401 W MEMORIAL RD STE 135
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1787
Mailing Address - Country:US
Mailing Address - Phone:405-286-1344
Mailing Address - Fax:405-849-4934
Practice Address - Street 1:4401 W MEMORIAL RD STE 135
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-1787
Practice Address - Country:US
Practice Address - Phone:405-286-1344
Practice Address - Fax:405-849-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty