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NPI Code Detail

MEDICARE: ALEXIS LABOUBE

MEDICARE: ALEXIS LABOUBE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1043678451
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS LABOUBE
Provider Business Mailing Address
First Line : 1213 W BIRMINGHAM ST
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74011-3040
Country : US
Telephone Number : 918-607-8037
Fax Number :
Provider Business Practice Location Address
First Line : 6216 S LEWIS AVE STE 102
Second Line :
City : TULSA
State : OK
Zip : 74136-1075
Country : US
Telephone Number : 918-960-7852
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2016
Last Update Date : 02/01/2016

Similar Medicare Providers

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1457816704 — MS. MARY WATERS-BILBO LPC
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Directions to “ ALEXIS LABOUBE ” Practice Location

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