Provider Demographics
NPI:1639172117
Name:RIHA, PAVEL (MD, PHD)
Entity Type:Individual
Prefix:
First Name:PAVEL
Middle Name:
Last Name:RIHA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 N. SHARTEL
Mailing Address - Street 2:STE 300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2421
Mailing Address - Country:US
Mailing Address - Phone:405-231-8882
Mailing Address - Fax:405-231-8884
Practice Address - Street 1:1226 N. SHARTEL
Practice Address - Street 2:STE 300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2421
Practice Address - Country:US
Practice Address - Phone:405-231-8882
Practice Address - Fax:405-231-8884
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19336174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100020740AMedicaid
OKG14652Medicare UPIN