Provider Demographics
NPI:1669641817
Name:TEEL, DEBORAH P (DPH)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:P
Last Name:TEEL
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 W CANYON RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74131-4006
Mailing Address - Country:US
Mailing Address - Phone:918-224-8315
Mailing Address - Fax:
Practice Address - Street 1:6711 W CANYON RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74131-4006
Practice Address - Country:US
Practice Address - Phone:918-224-8315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist