Organization
QUYEN HA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUYEN THANH HA MD (CEO)
(512) 799-9068
Entity
Organization
Contact information
Practice address
430 N MONTE VISTA ST, VALLEY VIEW REG HOSPITAL WOUND CARE CENTER, ADA, OK 74820-4610
(580) 272-1731
(580) 272-1720
Mailing address
PO BOX 12883, OKLAHOMA CITY, OK 73157-2883
(405) 858-0600
(405) 858-0602
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24063
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200247790A
—
OK
Enumeration date
06/12/2009
Last updated
02/14/2011
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