Healthcare Provider Details

I. General information

NPI: 1073322806
Provider Name (Legal Business Name): DANIELA ALCANTAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S PEORIA AVE
TULSA OK
74120-4429
US

IV. Provider business mailing address

10426 E 42ND ST
TULSA OK
74146-3744
US

V. Phone/Fax

Practice location:
  • Phone: 918-600-3100
  • Fax: 918-560-1399
Mailing address:
  • Phone: 918-908-0949
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: