Provider Demographics
NPI:1932174331
Name:MERENDA, JULES L (DO)
Entity Type:Individual
Prefix:DR
First Name:JULES
Middle Name:L
Last Name:MERENDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:PRICHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9001 S 101ST EAST AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5711
Mailing Address - Country:US
Mailing Address - Phone:918-392-7000
Mailing Address - Fax:918-392-7013
Practice Address - Street 1:9001 S 101ST EAST AVE STE 270
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133
Practice Address - Country:US
Practice Address - Phone:918-392-7000
Practice Address - Fax:918-392-7013
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3814207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100257270AMedicaid