Organization
PREMIERE PEDIATRICS PLLC
Active
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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