Basic Information
| Provider Information | |||||||||
| NPI: | 1538186424 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY HEALTH CARE L L C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10001 S WESTERN AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731392997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056914520 | ||||||||
| FaxNumber: | 4056910062 | ||||||||
| Practice Location | |||||||||
| Address1: | 10001 S WESTERN AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731392997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056914520 | ||||||||
| FaxNumber: | 4056910062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 11/14/2007 | ||||||||
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| AuthorizedOfficialLastName: | SINGH | ||||||||
| AuthorizedOfficialFirstName: | RAM | ||||||||
| AuthorizedOfficialMiddleName: | AKBAL | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4056914520 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | DC9051 | 01 | OK | RAILROAD MEDICARE ID | OTHER |