Healthcare Provider Details

I. General information

NPI: 1831332956
Provider Name (Legal Business Name): VIVIAN VIERA, MD, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N PORTER AVE SUITE 105
NORMAN OK
73071-6425
US

IV. Provider business mailing address

900 N PORTER AVE SUITE 105
NORMAN OK
73071-6425
US

V. Phone/Fax

Practice location:
  • Phone: 405-310-4422
  • Fax: 405-310-4424
Mailing address:
  • Phone: 405-310-4422
  • Fax: 405-310-4424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number18676
License Number StateOK

VIII. Authorized Official

Name: VIVIAN VIERA
Title or Position: OWNER
Credential: MD
Phone: 405-310-4422