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NPI Code Detail

MEDICARE: IRVIN YORDY AGUILERA HERNANDEZ

MEDICARE: IRVIN YORDY AGUILERA HERNANDEZ
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 : 1619725033
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRVIN YORDY AGUILERA HERNANDEZ
Provider Business Mailing Address
First Line : 2724 S 80TH EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74129-2701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2325 S HARVARD AVE
Second Line :
City : TULSA
State : OK
Zip : 74114-3300
Country : US
Telephone Number : 918-712-4301
Fax Number : 918-560-1399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2024
Last Update Date : 06/23/2026

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Directions to “ IRVIN YORDY AGUILERA HERNANDEZ ” Practice Location

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