Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | D62954 | MD |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 26218 | OK |
NPI | 1093752925 |
---|---|
Provider Name | Lieschen H Quiroz |
First Address | Okalhoma City, OK 73104-4313 |
Second Address | Oklahoma City, OK 73117-1039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 21/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
408412800 | (05) | MD |
I41269 | (02) | MD |