MRS. Teresa Deshawn Green, PHYSICIAN ASSISTANT

NPI #1295700425 in Owasso, Oklahoma

Provider Information

NPI Number: 1295700425
Entity Type: Individual
Name: MRS. Teresa Deshawn Green, PHYSICIAN ASSISTANT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PHYSICIAN ASSISTANT
Enumeration Date: Feb 21, 2006
Last Updated: May 31, 2023

Practice Location

Address: 8422 N 123RD EAST AVE
City: Owasso
State: Oklahoma
ZIP Code: 74055-2130
Phone: (918) 293-2140

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Physician Assistant - Medical — Medical	363AM0700X

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