Provider Demographics
NPI:1447632385
Name:BROOKS BILLING
Entity type:Organization
Organization Name:BROOKS BILLING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:ROCHELLE
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:BILLER
Authorized Official - Phone:405-887-7625
Mailing Address - Street 1:2821 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-3229
Mailing Address - Country:US
Mailing Address - Phone:405-887-7625
Mailing Address - Fax:405-237-1242
Practice Address - Street 1:2821 POPLAR DR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3229
Practice Address - Country:US
Practice Address - Phone:405-887-7625
Practice Address - Fax:405-237-1242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-27
Last Update Date:2015-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4131171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty