Organization
THE CHILDREN'S CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICO D GOMEZ (CEO)
(405) 789-6711
Entity
Organization
Contact information
Practice address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
(405) 789-0690
Mailing address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
(405) 789-0690
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2340
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100677110D
—
OK
Enumeration date
10/04/2006
Last updated
08/14/2024
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