Provider Demographics
NPI:1215211693
Name:THOMAS, SAUMY SUNNY
Entity Type:Individual
Prefix:MRS
First Name:SAUMY
Middle Name:SUNNY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SAUMY
Other - Middle Name:S
Other - Last Name:OLICKAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7317 E 112TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-2163
Mailing Address - Country:US
Mailing Address - Phone:918-808-0481
Mailing Address - Fax:
Practice Address - Street 1:15111 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-4123
Practice Address - Country:US
Practice Address - Phone:918-366-2910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK14300OtherOKLAHOMA STATE BOARD OF PHARMACY