Provider Demographics
NPI:1477204436
Name:ROBERTS, BRYONA D
Entity Type:Individual
Prefix:MS
First Name:BRYONA
Middle Name:D
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:XOSHIL
Other - Middle Name:
Other - Last Name:HEATH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7209 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-5216
Mailing Address - Country:US
Mailing Address - Phone:405-968-1116
Mailing Address - Fax:
Practice Address - Street 1:7209 NW 8TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-5216
Practice Address - Country:US
Practice Address - Phone:405-968-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist