Organization
GRACE MATA RUIDERA, M.D., P.C.
Active
Organization
GRACE MATA RUIDERA, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE MATA RUIDERA M.D. (PHYSICIAN/ OWNER)
(405) 732-3990
Entity
Organization
Contact information
Practice address
8121 NATIONAL AVE, SUITE 309, MIDWEST CITY, OK 73110-7530
(405) 732-3990
Mailing address
8121 NATIONAL AVE, SUITE 309, MIDWEST CITY, OK 73110-7530
(405) 732-3990
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19279
OK
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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