Provider Demographics
NPI:1629314976
Name:OCOMS PROFESSIONAL SERVICES LLC
Entity Type:Organization
Organization Name:OCOMS PROFESSIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-606-8950
Mailing Address - Street 1:PO BOX 890601
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73189-0601
Mailing Address - Country:US
Mailing Address - Phone:405-606-8950
Mailing Address - Fax:405-755-9113
Practice Address - Street 1:13301 N MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9369
Practice Address - Country:US
Practice Address - Phone:405-606-8950
Practice Address - Fax:405-755-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty