Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 4044 | OK |
NPI | 1003902768 |
---|---|
Provider Name | Dr. Trisha Lee Parks |
First Address | Tulsa, OK 74136-8307 |
Second Address | Tulsa, OK 74136-8307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 24/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200021410B | (05) | OK |
H87336 | (02) | |
H87336 | (02) | OK |