MEDICARE: DR. ANGELIQUE BARRETO M.D.,

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	207Q00000X	Family Medicine Physician	22192	OK

General Provider Information

NPI Number	:	1932168572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELIQUE BARRETO M.D.,

Provider Business Mailing Address
First Line	:	3418 NW 135TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-4009
Country	:	US
Telephone Number	:	405-286-1075
Fax Number	:	405-608-1075

Provider Business Practice Location Address
First Line	:	3418 NW 135TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-4009
Country	:	US
Telephone Number	:	405-286-1075
Fax Number	:	405-608-1075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	03/05/2020

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