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General NPI Number Information
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NPI Number | 1033922034
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Entity Type | Organization
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Legal Business Name | OKC CAR CRASH CLINIC LLC
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 4525 S KLEIN AVE STE 900
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-3839
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Country | US
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Telephone | 405-862-7274
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Fax |
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Provider Business Mailing Address
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Address Line | 4525 S KLEIN AVE STE 900
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-3839
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARTIN LOPEZ
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Credential | MD
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Telephone | 405-862-7274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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