Individual
SAURA C DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1145 S UTICA AVE STE 202, TULSA, OK 74104-4022
(918) 579-3130
(918) 579-3139
Mailing address
1145 S UTICA AVE STE 202, TULSA, OK 74104-4022
(918) 579-3130
(918) 579-3139
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2372
OK
363AM0700X
Medical Physician Assistant
2372
OK
363AS0400X
Surgical Physician Assistant
Primary
2372
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200550180A
—
OK
Enumeration date
01/31/2014
Last updated
04/08/2019
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