Individual
FADI SAID FARES ODETALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7409 KAYLEE WAY, OKLAHOMA CITY, OK 73132-4803
(405) 410-3894
Mailing address
7409 KAYLEE WAY, OKLAHOMA CITY, OK 73132-4803
(405) 410-3894
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
228354
OK
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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