Provider Demographics
NPI:1225527476
Name:KAP, PAU KHAN
Entity Type:Individual
Prefix:
First Name:PAU
Middle Name:KHAN
Last Name:KAP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2448 E 81ST ST STE 2045
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4271
Mailing Address - Country:US
Mailing Address - Phone:918-600-2966
Mailing Address - Fax:918-600-2965
Practice Address - Street 1:2448 E 81ST ST STE 2045
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4271
Practice Address - Country:US
Practice Address - Phone:918-600-2966
Practice Address - Fax:918-600-2965
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor