Healthcare Provider Details

I. General information

NPI: 1669486858
Provider Name (Legal Business Name): INTEGRIS CARDIOVSACULAR PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 NW 56TH ST SUITE 580
OKLAHOMA CITY OK
73112-4455
US

IV. Provider business mailing address

3433 NW 56TH ST SUITE 400
OKLAHOMA CITY OK
73112-4455
US

V. Phone/Fax

Practice location:
  • Phone: 405-917-3518
  • Fax:
Mailing address:
  • Phone: 405-951-4360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: PAUL SZYMANSKI
Title or Position: CEO
Credential:
Phone: 405-951-4360