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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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MASHEK, LARA DEL       
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: 5908 SE 15TH ST
MIDWEST CITY OK 73110-2618

Address last updated on 7/28/2024
Phone #: (405) 273-2270
Fax #:
County: POTTAWATOMIE
License: 25902
Dated: 8/1/2007
Expires: 8/1/2025
Temp. Lic. Issued: 7/26/2007
Temp. Lic. Expires: 9/22/2007
License Type: Medical Doctor
Specialty: Family Medicine
Urgent Care Medicine
Hospitalist
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2003
CME Year: 2025
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: AMERICAN BOARD OF FAMILY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
5908 SE 15TH ST
MIDWEST CITY OK 73110-2618

Phone #: (405) 273-2270
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
TRACI TRAN CARTER PA 1874
JARED JAMES CONATSER PA 2947
DELANA KAVIANI-FAR APRN 171
AMANDA KAYE ODOM PA 1017

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