Provider Demographics
NPI:1558727222
Name:BYRAM, SUMMER DAWN (BS)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:DAWN
Last Name:BYRAM
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 N LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-5108
Mailing Address - Country:US
Mailing Address - Phone:405-424-7711
Mailing Address - Fax:
Practice Address - Street 1:1501 W. COMMERCE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-1234
Practice Address - Country:US
Practice Address - Phone:405-424-7711
Practice Address - Fax:405-354-1926
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator