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General NPI Number Information
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NPI Number | 1518923564
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Entity Type | Individual
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Provider Name | ALICIA VANHOOSER MD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 07/10/2015
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Provider Practice Location Address
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Address Line | 316 W OWEN K GARRIOTT RD
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City | ENID
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State | OK
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Zip | 73701-5622
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Country | US
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Telephone | 580-249-3931
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Fax | 580-249-3773
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Provider Business Mailing Address
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Address Line | PO BOX 844737
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City | DALLAS
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State | TX
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Zip | 75284-4737
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Country | US
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Telephone | 580-249-3931
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Fax | 580-249-3773
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 16488
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License Number State | OK
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