Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 35562 | OK |
NPI | 1235429549 |
---|---|
Provider Name | Luis David Meggo Quiroz |
First Address | Tulsa, OK 74104-4243 |
Second Address | Tulsa, OK 74104-4243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2011 |
Last Update Date | 13/01/2021 |