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General NPI Number Information
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NPI Number | 1487172623
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Entity Type | Organization
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Legal Business Name | TULSA MICRO HOSPITAL, LLC
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 09/08/2017
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Provider Practice Location Address
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Address Line | 717 WEST 71ST STREET
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City | TULSA
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State | OK
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Zip | 74132
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Country | US
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Telephone | 713-202-3831
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 LOUISIANA ST FL 27
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City | HOUSTON
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State | TX
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Zip | 77002-7360
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Country | US
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Telephone | 713-202-3831
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN GRAUBART
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Credential |
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Telephone | 713-202-3831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist 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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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