| Ok Theta & Wellness | |
|
6410 N Santa Fe Ave Ste C Oklahoma City OK 73116-9127 | |
| (405) 607-9227 | |
| Not Available |
| Full Name | Ok Theta & Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 6410 N Santa Fe Ave Ste C, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Deana Glenn (OWNER) |
| Authorized Official Contact | 4056079227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ok Theta & Wellness 6410 N Santa Fe Ave Ste C Oklahoma City OK 73116-9127 Ph: (405) 607-9227 | Ok Theta & Wellness 6410 N Santa Fe Ave Ste C Oklahoma City OK 73116-9127 Ph: (405) 607-9227 |
| NPI Number | 1013711548 |
|---|---|
| Provider Enumeration Date | 04/03/2025 |
| Last Update Date | 07/11/2025 |
| Certification Date | 07/11/2025 |
| Medicare PECOS PAC ID | 6901310432 |
|---|---|
| Medicare Enrollment ID | O20250708002066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013711548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Deana Glenn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710366471 PECOS PAC ID: 8527371053 Enrollment ID: I20150713002529 |
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