Provider Demographics
NPI:1841581030
Name:AHREND, THOMAS SAMUEL (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:SAMUEL
Last Name:AHREND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 W 108TH CT
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-1815
Mailing Address - Country:US
Mailing Address - Phone:918-688-1858
Mailing Address - Fax:
Practice Address - Street 1:3707 W 108TH CT
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-1815
Practice Address - Country:US
Practice Address - Phone:918-688-1858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10040116207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology