Provider Demographics
NPI:1992151948
Name:PARTIDA, ANDREA (DO)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PARTIDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5550
Mailing Address - Country:US
Mailing Address - Phone:580-977-1902
Mailing Address - Fax:580-233-6106
Practice Address - Street 1:620 S MADISON ST STE 304
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-7270
Practice Address - Country:US
Practice Address - Phone:580-977-1902
Practice Address - Fax:580-233-6106
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK6228207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program