Provider Demographics
NPI:1194867028
Name:TERRANCE KHASTGIR MD PC
Entity Type:Organization
Organization Name:TERRANCE KHASTGIR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KHASGTIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-373-4340
Mailing Address - Street 1:3366 NW EXPRESSWAY ST
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4462
Mailing Address - Country:US
Mailing Address - Phone:405-373-4340
Mailing Address - Fax:405-373-2950
Practice Address - Street 1:3366 NW EXPRESSWAY ST
Practice Address - Street 2:SUITE 280
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4462
Practice Address - Country:US
Practice Address - Phone:405-373-4340
Practice Address - Fax:405-373-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18133207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE68570Medicare UPIN