Basic Information
Provider Information
NPI: 1215162979
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINDRIX
FirstName: CASEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 26901
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731260901
CountryCode: US
TelephoneNumber: 4052714351
FaxNumber: 4052718695
Practice Location
Address1: 920 STANTON L YOUNG BLVD # WP1140
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731045036
CountryCode: US
TelephoneNumber: 4052714351
FaxNumber: 4052718695
Other Information
ProviderEnumerationDate: 05/26/2009
LastUpdateDate: 07/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X27185OKY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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