PARKS, ANGELA FAY - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

PARKS, ANGELA FAY

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:	SSM HEALTH ST ANTHONY HOSPITAL REGIONAL BRAIN INSTITUTE 1000 N LEE AVE OKLAHOMA CITY OK 73102 Address last updated on 5/1/2024
Phone #:	(405) 272-7000
Fax #:
County:	OKLAHOMA
License:	5290
Dated:	7/25/2024
Expires:	3/31/2025
Temp. Ltr. Issued:	5/13/2024
Temp. Ltr. Expires:	7/25/2024
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2026

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.

Locations:	Hours:	Languages:
SSM HEALTH ST ANTHONY HOSPITAL REGIONAL BRAIN INSTITUTE 1000 N LEE AVE OKLAHOMA CITY OK 73102 Phone #: (405) 272-7000 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
PAVANKUMAR BOMMASAMUDRAM	MD	27309

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