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General NPI Number Information
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NPI Number | 1265260467
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Entity Type | Individual
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Provider Name | GINA M ALCAIDA
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 901 W 18TH ST
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City | ADA
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State | OK
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Zip | 74820-7423
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Country | US
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Telephone | 580-436-6130
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Fax | 580-436-6135
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Provider Business Mailing Address
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Address Line | 609 E BROADWAY
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City | ALLEN
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State | OK
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Zip | 74825-8164
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Country | US
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Telephone | 580-344-4847
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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