Healthcare Provider Details

I. General information

NPI: 1902935729
Provider Name (Legal Business Name): NEIL AGRAWAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 S YALE AVE STE 100A
TULSA OK
74136-1929
US

IV. Provider business mailing address

6600 S YALE AVE STE 1400
TULSA OK
74136-3331
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-0999
  • Fax: 918-592-1021
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number28267
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: