Individual
TITO MAURICE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2617 GENERAL PERSHING BLVD, OKLAHOMA CITY, OK 73107-6437
(405) 858-2700
Mailing address
2617 GENERAL PERSHING BLVD, OKLAHOMA CITY, OK 73107-6437
(405) 858-2700
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
B059872362
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U0938874903
CIGNA
IL
Enumeration date
06/06/2019
Last updated
10/18/2024
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