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General NPI Number Information
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NPI Number | 1902263569
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Entity Type | Organization
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Legal Business Name | ROSA J. RIOS
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 410 SW 38TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-6904
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Country | US
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Telephone | 405-570-1344
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Fax |
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Provider Business Mailing Address
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Address Line | 410 SW 38TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-6904
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Country | US
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Telephone | 405-570-1344
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MS. ROSA JAEL RIOS
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Credential | PA-C
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Telephone | 405-570-1344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 2624
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License Number State | OK
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