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NPI Code Detail

MEDICARE: JOHN PAUL HERNANDEZ ALCALA

MEDICARE: JOHN PAUL HERNANDEZ ALCALA
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
1246ZE0600XElectroneurodiagnostic Specialist/Technologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110231993OTHERTXBIRTH DATE

General Provider Information

NPI Number : 1962012534
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN PAUL HERNANDEZ ALCALA
Provider Business Mailing Address
First Line : 1715 S BALTIMORE AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-4807
Country : US
Telephone Number : 918-895-7680
Fax Number : 918-236-4646
Provider Business Practice Location Address
First Line : 1715 S BALTIMORE AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-4807
Country : US
Telephone Number : 918-895-7680
Fax Number : 918-236-4646
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2020
Last Update Date : 08/07/2020

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Directions to “ JOHN PAUL HERNANDEZ ALCALA ” Practice Location

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