Provider Demographics
NPI:1346476579
Name:SCHIESEL, BRENDA (DO)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:SCHIESEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10131 S YALE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-6007
Mailing Address - Country:US
Mailing Address - Phone:918-518-5144
Mailing Address - Fax:918-921-8155
Practice Address - Street 1:10131 S YALE AVE STE B
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-6007
Practice Address - Country:US
Practice Address - Phone:918-518-5144
Practice Address - Fax:918-921-8155
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK57562086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery