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General NPI Number Information
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NPI Number | 1912218868
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Entity Type | Organization
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Legal Business Name | MIGUEL SABEDRA PLLC
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 501 N 4TH ST
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City | MARLOW
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State | OK
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Zip | 73055-1807
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Country | US
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Telephone | 580-658-3203
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Fax | 580-658-8026
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Provider Business Mailing Address
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Address Line | 501 N 4TH ST
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City | MARLOW
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State | OK
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Zip | 73055-1807
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Country | US
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Telephone | 580-658-3203
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Fax | 580-658-8026
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Authorized Official
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Title or Position | OWNER
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Name | DR. MIGUEL REY SABEDRA
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Credential | M.D.
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Telephone | 580-658-3203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17356
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License Number State | OK
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