Provider Demographics
NPI:1114049293
Name:A TO Z PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:A TO Z PEDIATRICS, PLLC
Other - Org Name:PATRICE A. ASTON, DO, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:ADELE
Authorized Official - Last Name:ASTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-945-4990
Mailing Address - Street 1:3400 NW EXPRESSWAY ST
Mailing Address - Street 2:#C-815
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4493
Mailing Address - Country:US
Mailing Address - Phone:405-945-4990
Mailing Address - Fax:405-945-4991
Practice Address - Street 1:3400 NW EXPRESSWAY ST
Practice Address - Street 2:#C-815
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-945-4990
Practice Address - Fax:405-945-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2005208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100089060AMedicaid