Provider Demographics
NPI:1497092183
Name:DEAN, PAUL WILLAM (DVM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:WILLAM
Last Name:DEAN
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7222 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-4504
Mailing Address - Country:US
Mailing Address - Phone:918-610-3569
Mailing Address - Fax:
Practice Address - Street 1:7222 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-4504
Practice Address - Country:US
Practice Address - Phone:918-610-3569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2549174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian