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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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MENDOZA, JUSTIN-EDGAR VILLAFANIA       
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: SELECT SPECIALTY HOSPITAL-TULSA
744 W 9TH ST
TULSA OK 74127
Address last updated on 9/24/2024
Phone #: (918) 932-3700
Fax #:
County: TULSA
License: 6115
Dated: 10/25/2023
Expires: 1/31/2025
License Type: Physical Therapist
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:
SELECT SPECIALTY HOSPITAL-TULSA
744 W 9TH ST
TULSA OK 74127
Phone #: (918) 932-3700
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
HALEY NICOLE MATTHEWS TA 3717
HALEY NICOLE MATTHEWS TA 3717
AUTUMN NICOLE PERRY TA 3411
AUTUMN NICOLE PERRY TA 3411

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