Provider Demographics
NPI:1992259501
Name:TRANQUIL PSYCHIATRY CLINIC,LLC
Entity type:Organization
Organization Name:TRANQUIL PSYCHIATRY CLINIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:AZHAR
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-430-9196
Mailing Address - Street 1:333 NW 5TH ST
Mailing Address - Street 2:APT. NO. 1010
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-3080
Mailing Address - Country:US
Mailing Address - Phone:210-430-9196
Mailing Address - Fax:888-745-3175
Practice Address - Street 1:333 NW 5TH ST
Practice Address - Street 2:APT. NO. 1010
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-3080
Practice Address - Country:US
Practice Address - Phone:210-430-9196
Practice Address - Fax:888-745-3175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK319922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty