Healthcare Provider Details

I. General information

NPI: 1508430158
Provider Name (Legal Business Name): CRISTIAN ANDRES ZAPATA RINCON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 E 15TH ST STE 119
TULSA OK
74104-4643
US

IV. Provider business mailing address

2510 E 15TH ST STE 119
TULSA OK
74104-4643
US

V. Phone/Fax

Practice location:
  • Phone: 539-222-7533
  • Fax:
Mailing address:
  • Phone: 539-222-7533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: