Provider Demographics
NPI:1518714054
Name:BILLEN, DAVID TYLER
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:TYLER
Last Name:BILLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 W SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-5233
Mailing Address - Country:US
Mailing Address - Phone:405-308-5396
Mailing Address - Fax:
Practice Address - Street 1:2701 W I 44 SERVICE RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3775
Practice Address - Country:US
Practice Address - Phone:866-848-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty