Organization
ESEC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOLENE J ARVIEUX (ADMINISTRATOR)
(405) 463-3484
Entity
Organization
Contact information
Practice address
3705 NW 63RD ST, STE 100, OKLAHOMA CITY, OK 73116-1905
(405) 463-3484
(405) 608-4259
Mailing address
PO BOX 268867, OKLAHOMA CITY, OK 73126-8867
(405) 842-4850
(405) 848-2425
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0079
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200089950A
—
OK
01
—
7703855
AETNA
OK
01
—
P00317452
MEDICARE RAILROAD
OK
Enumeration date
07/11/2006
Last updated
11/19/2013
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