Provider Demographics
NPI:1629121470
Name:WESTCARE EMERGENCY PHYSICIANS PLLC
Entity Type:Organization
Organization Name:WESTCARE EMERGENCY PHYSICIANS PLLC
Other - Org Name:BROOKHAVEN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:L
Authorized Official - Last Name:WAUTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-310-2484
Mailing Address - Street 1:3770 W ROBINSON ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3661
Mailing Address - Country:US
Mailing Address - Phone:405-310-2484
Mailing Address - Fax:
Practice Address - Street 1:3770 W ROBINSON ST
Practice Address - Street 2:SUITE 116
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3661
Practice Address - Country:US
Practice Address - Phone:405-310-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty