Provider Demographics
NPI:1003902768
Name:PARKS, TRISHA LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:TRISHA
Middle Name:LEE
Last Name:PARKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:L
Other - Last Name:PARKS-BEAKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6565 S YALE AVE
Mailing Address - Street 2:STE 610
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8307
Mailing Address - Country:US
Mailing Address - Phone:918-502-2200
Mailing Address - Fax:918-502-2210
Practice Address - Street 1:6565 S YALE AVE
Practice Address - Street 2:STE 610
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8307
Practice Address - Country:US
Practice Address - Phone:918-502-2200
Practice Address - Fax:918-502-2210
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4044207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200021410BMedicaid
H87336Medicare UPIN
OKH87336Medicare UPIN
OK243430900Medicare ID - Type Unspecified
OK200021410BMedicaid