Provider Demographics
NPI:1720846835
Name:SUPERIOR FAMILY CARE, LLC
Entity Type:Organization
Organization Name:SUPERIOR FAMILY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAIYID
Authorized Official - Middle Name:ISBAH
Authorized Official - Last Name:MAUDUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:405-818-8392
Mailing Address - Street 1:4119 MOORGATE CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-9789
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1421 NW 122ND ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-8028
Practice Address - Country:US
Practice Address - Phone:405-818-8392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty