Provider Demographics
NPI:1992174304
Name:UAP OF OKLAHOMA, INC.
Entity type:Organization
Organization Name:UAP OF OKLAHOMA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIA PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-713-3547
Mailing Address - Street 1:15305 DALLAS PKWY
Mailing Address - Street 2:1600
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4637
Mailing Address - Country:US
Mailing Address - Phone:972-713-3547
Mailing Address - Fax:
Practice Address - Street 1:8100 S WALKER AVE
Practice Address - Street 2:BLDG C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9402
Practice Address - Country:US
Practice Address - Phone:405-602-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty