Basic Information
| Provider Information | |||||||||
| NPI: | 1609918416 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NASR | ||||||||
| FirstName: | FADI | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4120 W MEMORIAL RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731209320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057483300 | ||||||||
| FaxNumber: | 4057491671 | ||||||||
| Practice Location | |||||||||
| Address1: | 4120 W MEMORIAL RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731209320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057483300 | ||||||||
| FaxNumber: | 4057491671 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 10/11/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 22413 | OK | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.