Provider Demographics
NPI:1932582624
Name:WILLIAM BENDURE MD, PLLC
Entity Type:Organization
Organization Name:WILLIAM BENDURE MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BLAINE
Authorized Official - Last Name:BENDURE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-816-6483
Mailing Address - Street 1:143 WRIGHT CIR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1301
Mailing Address - Country:US
Mailing Address - Phone:405-816-6483
Mailing Address - Fax:
Practice Address - Street 1:4221 S WESTERN AVE
Practice Address - Street 2:SUITE 5000
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3447
Practice Address - Country:US
Practice Address - Phone:405-644-5160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK286522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty