Healthcare Provider Details

I. General information

NPI: 1205937224
Provider Name (Legal Business Name): OKLAHOMA CARDIOVASCULAR ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 N FRANCIS AVE
OKLAHOMA CITY OK
73118-6040
US

IV. Provider business mailing address

PO BOX 268842
OKLAHOMA CITY OK
73126-8842
US

V. Phone/Fax

Practice location:
  • Phone: 405-840-0088
  • Fax: 405-840-0133
Mailing address:
  • Phone: 405-608-1200
  • Fax: 405-608-1250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PATRICK HOLLOWAY
Title or Position: CEO
Credential:
Phone: 405-608-3800