Provider Demographics
NPI:1093148488
Name:THOMAS D. URICE M.D. LLC
Entity Type:Organization
Organization Name:THOMAS D. URICE M.D. LLC
Other - Org Name:THOMAS D URICE M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING MGR
Authorized Official - Prefix:
Authorized Official - First Name:BETTI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ESTEP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-521-1969
Mailing Address - Street 1:2413 PALMER CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6301
Mailing Address - Country:US
Mailing Address - Phone:405-321-5322
Mailing Address - Fax:405-321-5348
Practice Address - Street 1:2413 PALMER CIR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6301
Practice Address - Country:US
Practice Address - Phone:405-321-5322
Practice Address - Fax:405-321-5348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13255207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty