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General NPI Number Information
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NPI Number | 1487614699
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Entity Type | Individual
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Provider Name | JUAN A BROU M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5300 N GRAND BLVD SUITE 205
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-5647
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Country | US
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Telephone | 405-945-0001
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Fax | 405-945-0004
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Provider Business Mailing Address
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Address Line | 5300 N GRAND BLVD SUITE 205
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-5647
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Country | US
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Telephone | 405-945-0001
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Fax | 405-945-0004
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 17485
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License Number State | OK
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