Premier Provider Health Oklahoma, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PREMIER PROVIDER HEALTH OKLAHOMA, PA

Practice address

1120 S Utica Ave
Tulsa, OK 74104-4012

Phone

(512) 202-3830

Fax

(512) 354-1106

NPI assigned

Mar 1, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Han Pham Hulen, MD

Title

President and Owner

Phone

(214) 274-1507

Specialties & licenses 3

Addresses

Other names 1

• Freedom Wound Physicians Oklahoma, PA Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1124612221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHISHOLM TRAIL RD STE 5200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815090",
            "telephone_number": "512-202-3830",
            "fax_number": "512-354-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "512-202-3830",
            "fax_number": "512-354-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PROVIDER HEALTH OKLAHOMA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "HULEN",
        "authorized_official_first_name": "HAN",
        "authorized_official_middle_name": "PHAM",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "214-274-1507",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Wound Physicians Oklahoma, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Medical Inc.
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• Premier Orthopedic Specialists of Tulsa
• Premier Pediatric Home Health LLC
• Premise Health of Oklahoma Medical PC
• Premise Health of Oklahoma Medical PC
• Premise Health of Oklahoma Medical PC
• Premise Health of Oklahoma Medical PC
• Premise Health of Oklahoma Medical PC

• Internal Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.