Organization
PROPHYLAXIS HEALTHCARE LLC
Active
Other names
Axis HealthCare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERT SANCHEZ (CEO)
(918) 970-4719
Entity
Organization
Contact information
Practice address
11911 S MEMORIAL DR, BIXBY, OK 74008-2030
(918) 943-3790
(918) 943-3793
Mailing address
PO BOX 334, BIXBY, OK 74008-0334
(918) 970-4719
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
12810
OK
207R00000X
Internal Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
06/03/2011
Last updated
06/10/2021
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