NPI 1316728702 · live from the CMS NPI Registry
Healthtexas Provider Network
Internal Medicine, Cardiovascular Disease in Idabel, OK. National Provider Identifier 1316728702, active.
NPI record
| NPI | 1316728702 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Cardiovascular Disease 207RC0000X |
| Practice location | 4 Se Ave A, Idabel, OK 74745 |
| Practice phone | 580-208-2700 |
| Mailing address | 301 N Washington Ave, Dallas, TX 75246 |
| Enumerated | October 11, 2023 |
| Last updated | April 23, 2024 |
| Authorized official | Michelle Telford, Managed Care Consultant |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Cardiovascular Disease primary | 207RC0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.