Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 8 | OK |
N | 222Z00000X | Podiatrist | 8 | OK |
N | 225000000X | Orthotic Fitter | 8 | OK |
NPI | 1619945128 |
---|---|
Provider Name | Gary S Trexler |
First Address | Oklahoma City, OK 73117-1039 |
Second Address | Oklahoma City, OK 73117-1039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 08/07/2007 |