# GAMBLE FAMILY MEDICAL PRACTICE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Medical Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013510775
- **Authorized official:** TANDALEO GAMBLE NURSE PRACTITIONER (CEO)
- **Authorized official phone:** (918) 760-2200

## Contact information

- **Practice address:** 4134 S HARVARD AVE STE B3, TULSA, OK 74135-2613
- **Practice address phone:** (918) 442-2236
- **Practice address fax:** (918) 794-2333
- **Mailing address:** 4134 S HARVARD AVE STE B3, TULSA, OK 74135-2613
- **Mailing address phone:** (918) 442-2236
- **Mailing address fax:** (918) 794-2333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/17/2020
- **Last updated:** 04/12/2022