MRS. PHYLLIS R DESHAZO (NPI# 1689077612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689077612 |
| Entity Type | Individual |
| Full Name | MRS. PHYLLIS R DESHAZO |
| Credential | REEGT, CNIM |
| Practice Address |
409 E California Ave Oklahoma City OK 73104-4224 |
| Practice Telephone | 4058417826 |
| Practice Fax Number | 4058417827 |
| Mailing Telephone | 4058417826 |
| Mailing Fax Number | 4058417827 |
| Enumeration Date | 2014-10-05 |
| Last Update Date | 2014-10-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
466 | OK | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
409 E CALIFORNIA AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73104-4224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710965801 | Echelon Medical LLC | Durable Medical Equipment & Medical Supplies | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2006-01-09 |
| 1588017594 | Kevin Sadosky | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2016-07-14 |
| 1114383163 | Darilyn Jordan | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2016-01-06 |
| 1730575366 | Joshua Adam Zwosta | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2015-04-10 |
| 1336533686 | Steven Craig Williams | Specialist | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2015-03-25 |
| 1861897472 | Katherine Roberts | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2014-10-24 |
| 1093119968 | Greg Pace | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2014-10-21 |
| 1477957025 | Vaishali Patel | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2014-10-10 |
| 1609203553 | Rok Medical Management, LLC | Clinic/Center | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2013-10-08 |
| 1972867026 | Elizabeth Eby | Audiologist | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2012-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356979645 | Kayla Campbell | Dietitian, Registered | Stephenson Cancer Center, 800 Ne 10th Street, Oklahoma City, OK 73104 | 2020-03-31 |
| 1447715453 | Roman Michael Garcia | Dentist | Ou Children's Physicians - Dental Clinic, 1200 Children's Ave, 8f, Oklahoma City, OK 73104 | 2019-02-04 |
| 1265902340 | Jenna Lyn Celii | Registered Nurse | 920 Sl Young Blvd Ste 1140, Oklahoma City, OK 73104 | 2018-11-30 |
| 1407337462 | Opus Medical, LLC | Psychiatry & Neurology | 4 Ne 10th St Suite 467, Oklahoma City, OK 73104 | 2018-08-27 |
| 1316433295 | Syed Muhammad Shakaib Quadri | Pathology | 940 Stanton L. Young Blvd., Bmsb 451, Oklahoma City, OK 73104 | 2018-07-03 |
| 1447746417 | Nimrah Bader | Internal Medicine | 800 Stanton L. Young Blvd., Aat 6300, Oklahoma City, OK 73104 | 2018-07-02 |
| 1417440793 | Helen Judith Turkson Apetor | Nurse Practitioner | 700 Ne 13th, Oklahoma City, OK 73104 | 2018-06-11 |
| 1003307935 | Mary Katlin Nixon | Obstetrics & Gynecology | 800 Stanton L Young Blvd Ste 2319, Oklahoma City, OK 73104 | 2018-05-26 |
| 1558851220 | Bryce Yohannan | Student in an Organized Health Care Education/Training Program | 800 Stanton L Young Blvd, Aat 6300, Oklahoma City, OK 73104 | 2018-05-17 |
| 1346746690 | Kacy Anne Richburg | Orthopaedic Surgery | 711 Stanton L Young Blvd Ste 111, Oklahoma City, OK 73104 | 2018-04-04 |
| Find all providers in zip 73104 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316482284 | Us Neurologic, Pllc | Specialist/Technologist, Other | 3000 W. Memorial Rd., Ste 123-330, Oklahoma City, OK 73120 | 2016-12-30 |
| 1144672445 | Red River Neurodiagnostics, LLC | Specialist/Technologist, Other | 2410 W Memorial Rd Ste C, #609, Oklahoma City, OK 73134-8048 | 2016-07-11 |
| 1053784934 | Reggie Vulgamore | Specialist/Technologist, Other | 12301 N Mcarthur Blvd Apt 1811, Oklahoma City, OK 73142-3056 | 2015-11-02 |
| 1629457387 | Halstead Monitoring LLC | Specialist/Technologist, Other | 2226 Shadowlake Dr, Oklahoma City, OK 73159-7440 | 2015-05-27 |
| 1639573140 | Leslie Castro | Specialist/Technologist, Other | 405 E California Ave, Oklahoma City, OK 73104 | 2014-10-13 |
| 1609192624 | Robin Elizabeth Jones | Specialist/Technologist, Other | 4208 Tamarisk Dr, Oklahoma City, OK 73120-8114 | 2010-04-15 |
| 1114383163 | Darilyn Jordan | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2016-01-06 |
| 1730575366 | Joshua Adam Zwosta | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2015-04-10 |
| 1861897472 | Katherine Roberts | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2014-10-24 |
| 1093119968 | Greg Pace | Specialist/Technologist, Other | 409 E California Ave, Oklahoma City, OK 73104-4224 | 2014-10-21 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73104 |
Please comment or provide details below to improve the information on MRS. PHYLLIS R DESHAZO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.