Provider Demographics
NPI:1205692134
Name:PETE, SPECHAL
Entity type:Individual
Prefix:
First Name:SPECHAL
Middle Name:
Last Name:PETE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8537 HURST CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-4402
Mailing Address - Country:US
Mailing Address - Phone:405-537-2119
Mailing Address - Fax:
Practice Address - Street 1:8537 HURST CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-4402
Practice Address - Country:US
Practice Address - Phone:405-537-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist