MEDICARE: ADVANCED PAIN SPECIALISTS OF TULSA, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	207LP2900X	Pain Medicine (Anesthesiology) Physician
3	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
4	291U00000X	Clinical Medical Laboratory	37D2039747	OK
5	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1518230002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PAIN SPECIALISTS OF TULSA, PLLC

Provider Business Mailing Address
First Line	:	11063D S MEMORIAL DR # 518
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-7362
Country	:	US
Telephone Number	:	918-899-2751
Fax Number	:

Provider Business Practice Location Address
First Line	:	3840 S 103RD EAST AVE STE 100
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-2445
Country	:	US
Telephone Number	:	918-879-1700
Fax Number	:	918-879-1701

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. HUGO SALGUERO
Credential	:	MD
Telephone Number	:	918-921-9700

Provider Enumeration Date	:	02/15/2012
Last Update Date	:	05/31/2024

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