| Avenstar Pain Specialists, Pllc | |
|
1732 S Sooner Rd Midwest City OK 73110 | |
| (405) 438-0913 | |
| Not Available |
| Full Name | Avenstar Pain Specialists, Pllc |
|---|---|
| Speciality | Pain Medicine |
| Location | 1732 S Sooner Rd, Midwest City, Oklahoma |
| Authorized Official Name and Position | Steve Eric Randall (OWNER) |
| Authorized Official Contact | 4054380913 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avenstar Pain Specialists, Pllc 1732 S Sooner Rd Midwest City OK 73110 Ph: (405) 438-0913 | Avenstar Pain Specialists, Pllc 1732 S Sooner Rd Midwest City OK 73110 Ph: (405) 438-0913 |
| NPI Number | 1104219385 |
|---|---|
| Provider Enumeration Date | 03/11/2015 |
| Last Update Date | 03/06/2025 |
| Medicare PECOS PAC ID | 1153632344 |
|---|---|
| Medicare Enrollment ID | O20150615000790 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104219385 | NPI | - | NPPES |
| 200341890A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | N4691 (Texas) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 2493 (Oklahoma) | Primary |
| Provider Name | Steve E Randall |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1902078298 PECOS PAC ID: 7618016627 Enrollment ID: I20110915000634 |
| Provider Name | Andrew Scott Jimerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376079780 PECOS PAC ID: 9739514027 Enrollment ID: I20200114002945 |
| Provider Name | Kendra Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609618776 PECOS PAC ID: 8820484884 Enrollment ID: I20240819004133 |
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Midway Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 351 N Air Depot Blvd, Suite Bb, Midwest City, OK 73110 Phone: 405-610-3600 Fax: 405-610-3607 | |
P David Margolis Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8121 National Ave, Suite 300, Midwest City, OK 73110 Phone: 405-737-9820 Fax: 405-733-0779 |