Provider Demographics
NPI:1518396860
Name:KEVIN TEAL, M.D., P.C.
Entity Type:Organization
Organization Name:KEVIN TEAL, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ARMEDIX LLC
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:405-418-4506
Mailing Address - Street 1:PO BOX 248855
Mailing Address - Street 2:DEPT. 62
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8855
Mailing Address - Country:US
Mailing Address - Phone:855-457-8674
Mailing Address - Fax:405-285-1638
Practice Address - Street 1:4833 INTEGRIS PKWY
Practice Address - Street 2:STE 200
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8864
Practice Address - Country:US
Practice Address - Phone:855-457-8674
Practice Address - Fax:405-285-1638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29001207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty