# BJT MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bryan J Treacy, MD LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992960231
- **Authorized official:** DR. BRYAN J TREACY MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (405) 793-9171

## Contact information

- **Practice address:** 1035 SW 19TH ST, SUITE B, MOORE, OK 73160-2883
- **Practice address phone:** (405) 793-9171
- **Practice address fax:** (405) 793-0815
- **Mailing address:** PO BOX 6847, MOORE, OK 73153-0847
- **Mailing address phone:** (405) 793-9171
- **Mailing address fax:** (405) 793-0815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 23781 | OK | Yes |

## Other

- **Enumeration date:** 07/25/2008
- **Last updated:** 04/24/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200263670A | — | OK |