| Al-botros Pllc | |
|
1111 N Lee Ave Ste 105 Oklahoma City OK 73103-2620 | |
| (405) 600-6730 | |
| (405) 600-6750 |
| Full Name | Al-botros Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1111 N Lee Ave Ste 105, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Adonis Simon Al-botros (PHYSICIAN) |
| Authorized Official Contact | 4056006730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Al-botros Pllc 1111 N Lee Ave Ste 105 Oklahoma City OK 73103-2620 Ph: (405) 600-6730 | Al-botros Pllc 1111 N Lee Ave Ste 105 Oklahoma City OK 73103-2620 Ph: (405) 600-6730 |
| NPI Number | 1063573459 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 02/07/2012 |
| Medicare PECOS PAC ID | 7911958541 |
|---|---|
| Medicare Enrollment ID | O20050322000407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063573459 | NPI | - | NPPES |
| 100224280A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 21751 (Oklahoma) | Primary |
| Provider Name | Hashib D Faruque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225006570 PECOS PAC ID: 2365347069 Enrollment ID: I20031205000072 |
| Provider Name | Adonis S Al Botros |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316994551 PECOS PAC ID: 3779538830 Enrollment ID: I20050322000436 |
| Provider Name | Paula J Rother |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780184754 PECOS PAC ID: 2567719925 Enrollment ID: I20180717003151 |
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