Individual
TAI LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4500 N KICKAPOO AVE, SHAWNEE, OK 74804-1208
(405) 878-0244
Mailing address
4500 N KICKAPOO AVE, SHAWNEE, OK 74804-1208
(405) 878-0244
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
I-10796
OK
Other
Enumeration date
06/12/2026
Last updated
06/12/2026
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