Individual
DR. CARLOS GOMEZ-MEADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
800 W. BOISE CIRCLE, SUITE 400, BROKEN ARROW, OK 74012
(918) 307-0215
(918) 250-7669
Mailing address
800 W. BOISE CIRCLE, SUITE 400, BROKEN ARROW, OK 74012
(918) 307-0215
(918) 250-7669
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
P0829
TX
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
6596
OK
207ND0101X
MOHS-Micrographic Surgery Physician
P0829
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302669201
—
TX
Enumeration date
04/19/2007
Last updated
08/25/2020
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