Healthcare Provider Details

I. General information

NPI: 1083977110
Provider Name (Legal Business Name): ARMANDO PRADO BHRS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 06/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11212 N MAY AVE STE. 208
OKLAHOMA CITY OK
73120-6336
US

IV. Provider business mailing address

11212 N MAY AVE STE. 208
OKLAHOMA CITY OK
73120-6336
US

V. Phone/Fax

Practice location:
  • Phone: 405-708-6331
  • Fax: 405-708-6331
Mailing address:
  • Phone: 405-708-6331
  • Fax: 405-708-6331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: