Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 4978 | OK |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 61841 | MN |
NPI | 1013063635 |
---|---|
Provider Name | Dr. Royce Lee Bargas |
First Address | Oklahoma City, OK 73101-3324 |
Second Address | Edmond, OK 73013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 15/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | CO |