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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

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TAN, SALLY QUE POA       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 1110 NORTH CLASSEN BOULEVARD
SUITE 204
OKLAHOMA CITY OK 73106-6840

Address last updated on 9/13/2023
Phone #: (405) 319-1622
Fax #: (405) 319-1575
County: OKLAHOMA
License: 19992
Dated: 10/16/1996
Expires: 10/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: PHILIPPINE MEDICAL SCHOOLS
Graduated: 6 / 1980
CME Year: 2027
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: Aetna Elect Choice
Aetna Managed Choice
Aetna PPO
Beechstreet PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
Coventry Health Care National Network
First Health
HealthChoice
Humana Medicare Advantage PPO
Oklahoma Health Network PPO
OSMA Health (formerly Plico PPO)
PHCS (Private Healthcare Systems)
PPO Oklahoma
United Healthcare Options PPO
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
Locations: Hours: Languages:
1110 NORTH CLASSEN BOULEVARD
SUITE 204
OKLAHOMA CITY OK 73106-6840

Phone #: (405) 319-1622
Fax #: (405) 319-1575
Mon: 10:00AM - 5:00PM
Tue: 10:00AM - 5:00PM
Wed: 10:00AM - 12:00PM
Thu: 10:00AM - 5:00PM
Fri: 10:00AM - 12:00PM
Sat:
Sun:

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