Provider Demographics
NPI:1598082737
Name:THOMAS, MEBIN BABU (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MEBIN
Middle Name:BABU
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2316 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2406
Mailing Address - Country:US
Mailing Address - Phone:405-605-3395
Mailing Address - Fax:405-605-3673
Practice Address - Street 1:2316 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2406
Practice Address - Country:US
Practice Address - Phone:405-605-3395
Practice Address - Fax:405-605-3673
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK1887363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical