Organization
LIFE PSYCHIATRIC CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEBIN BABU THOMAS PA-C (MEMBER)
(405) 414-9139
Entity
Organization
Contact information
Practice address
609 S KELLY AVE STE B2, EDMOND, OK 73003-5725
(405) 724-6871
(405) 726-0423
Mailing address
609 S KELLY AVE STE B2, EDMOND, OK 73003-5725
(405) 724-6871
(405) 726-0423
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201012720A
—
OK
Enumeration date
08/04/2021
Last updated
04/12/2022
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