Provider Demographics
NPI:1689929846
Name:TASI, NIUOLEAVA LOPA JR
Entity Type:Individual
Prefix:MR
First Name:NIUOLEAVA
Middle Name:LOPA
Last Name:TASI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 PURDUE CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-2754
Mailing Address - Country:US
Mailing Address - Phone:405-326-3579
Mailing Address - Fax:
Practice Address - Street 1:1910 PURDUE CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-2754
Practice Address - Country:US
Practice Address - Phone:405-326-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst