BJT MD PLLC
Organization Active NPI Obstetrics & Gynecology Physician · Moore, OK
NPI 1992960231 · NPPES record last updated Apr 24, 2012
Key facts
- NPI
- 1992960231
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 23781 (OK)
- Legal business name
- BJT MD PLLC
- Practice address
- 1035 SW 19TH St
Suite B
Moore, OK 73160-2883 - Phone
- (405) 793-9171
- Fax
- (405) 793-0815
- NPI assigned
- Jul 25, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Bryan J Treacy, MD
- Title
- Owner/Physician
- Phone
- (405) 793-9171
Practitioners 1
-
James D Burroughs, DC, APRN C-NP.
National Provider Directory
Locations
1035 SW 19th St
Ste B
Moore, OK 73160
Phone (405) 793-9171
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | 23781 | OK | Yes |
Addresses
Primary practice location
1035 SW 19TH St
Suite B
Moore, OK 73160-2883
Mailing address
PO Box 6847
Moore, OK 73153-0847
Phone (405) 793-9171
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200263670A | Medicaid | OK |
Other names
- Bryan J Treacy, MD LLC
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.