MEDICARE: DR. OSCAR EUGENIO MASTERS III M.D.

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
1	208200000X	Plastic Surgery Physician	BP1-0034952	TX
2	2086S0122X	Plastic and Reconstructive Surgery Physician	Q0972	TX
3	2086S0122X	Plastic and Reconstructive Surgery Physician	31056	OK

General Provider Information

NPI Number	:	1700011756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OSCAR EUGENIO MASTERS III M.D.

Provider Business Mailing Address
First Line	:	10900 HEFNER POINTE DR STE 505
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-5006
Country	:	US
Telephone Number	:	405-246-0391
Fax Number	:	405-246-0392

Provider Business Practice Location Address
First Line	:	5300 N GRAND BLVD
Second Line	:	#205
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5647
Country	:	US
Telephone Number	:	405-945-0001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2009
Last Update Date	:	09/14/2021

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