Healthcare Provider Details

I. General information

NPI: 1053405951
Provider Name (Legal Business Name): ALINA C JUSTIZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALINA JUSTIZ MD

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 01/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 CROSSROADS BLVD STE 100
NORMAN OK
73072-3334
US

IV. Provider business mailing address

1215 CROSSROADS BLVD STE 100
NORMAN OK
73072-3334
US

V. Phone/Fax

Practice location:
  • Phone: 405-606-8920
  • Fax: 405-310-6720
Mailing address:
  • Phone: 405-606-8920
  • Fax: 405-310-6720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberM2358
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number27481
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: