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General NPI Number Information
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NPI Number | 1245136456
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Entity Type | Individual
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Provider Name | DIEGO KEATON ARVIZU
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Gender | Male
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Dates
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Enumeration Date | 10/15/2026
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Last Update Date | 10/15/2026
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Provider Practice Location Address
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Address Line | 721 W QUEENS ST
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City | BROKEN ARROW
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State | OK
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Zip | 74012-1767
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Country | US
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Telephone | 479-318-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 4414 E 14TH PL
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City | TULSA
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State | OK
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Zip | 74112-6110
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Country | US
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Telephone | 918-908-0356
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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