Healthcare Provider Details

I. General information

NPI: 1508976648
Provider Name (Legal Business Name): RIAZ A. SIRAJUDDIN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10413 GREENBRIAR PKWY
OKLAHOMA CITY OK
73159-7656
US

IV. Provider business mailing address

10413 GREENBRIAR PKWY
OKLAHOMA CITY OK
73159-7656
US

V. Phone/Fax

Practice location:
  • Phone: 405-691-4665
  • Fax: 405-378-7628
Mailing address:
  • Phone: 405-691-4665
  • Fax: 405-378-7628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RIAZ AHMED SIRAJUDDIN
Title or Position: OWNER
Credential: MD
Phone: 405-691-4665