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Organization

PREMIERE PEDIATRICS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLEN DIAZ APRN (OFFICER)
(405) 364-6432
Entity
Organization

Contact information

Practice address
3261 24TH AVE NW STE 101, NORMAN, OK 73069-6666
(405) 364-6432
(405) 364-0090
Mailing address
3261 24TH AVE NW STE 101, NORMAN, OK 73069-6666
(405) 364-6432
(405) 364-0090

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
02/19/2007
Last updated
04/27/2026
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