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NPI Code Detail

MEDICARE: MICHAEL ESTRADA DO

MEDICARE: MICHAEL ESTRADA DO
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
1207Q00000XFamily Medicine PhysicianW3792TX

General Provider Information

NPI Number : 1649965955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ESTRADA DO
Provider Business Mailing Address
First Line : 7501 RIVERSIDE PKWY
Second Line :
City : TULSA
State : OK
Zip : 74136-5056
Country : US
Telephone Number : 918-710-4200
Fax Number : 918-403-6331
Provider Business Practice Location Address
First Line : 7501 RIVERSIDE PKWY
Second Line :
City : TULSA
State : OK
Zip : 74136-5056
Country : US
Telephone Number : 918-710-4200
Fax Number : 918-403-6331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2023
Last Update Date : 03/10/2026

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