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General NPI Number Information
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NPI Number | 1548087786
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Entity Type | Individual
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Provider Name | OMAR FLORES VALDEZ
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Gender | Male
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 4404 S PEORIA AVE
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City | TULSA
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State | OK
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Zip | 74105-3926
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Country | US
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Telephone | 918-749-1577
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Fax |
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Provider Business Mailing Address
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Address Line | 4404 S PEORIA AVE
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City | TULSA
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State | OK
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Zip | 74105-3926
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20662
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License Number State | OK
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