Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

State of Oklahoma Medical Center LLC

Organization Behavioral Neurology & Neuropsychiatry Physician · NPI 1740177401

State of Oklahoma Medical Center LLC is a Behavioral Neurology & Neuropsychiatry Physician in Oklahoma City, Oklahoma. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

101 Park Ave Ste 1300
Oklahoma City, OK 73102-7216
Phone: (510) 456-8143
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Behavioral Neurology & Neuropsychiatry Physician Taxonomy 2084B0040X

Record details

NPI number1740177401
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cristine Hernandez — Ceo · (510) 456-8143
NPI enumeratedJune 23, 2025
Last updated in NPPESJune 23, 2025
Certification dateJune 23, 2025
Mailing address4570 S Eastern Ave Ste 28, Las Vegas, NV 89119-6183

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