Organization
PULMONARY CARE INNOVATIONS PLLC
Active
Organization
PULMONARY CARE INNOVATIONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER M BOOMER MD (SOLE OWNER- AUTHORIZED OFFICIAL)
(918) 638-4223
Entity
Organization
Contact information
Practice address
2832 E 101ST ST, TULSA, OK 74137-5601
(918) 494-9288
(918) 494-9289
Mailing address
1515 TOWER DR, MOORE, OK 73160-6181
(405) 307-6668
(405) 701-6170
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QE0002X
Emergency Care Clinic/Center
—
—
Other
Enumeration date
12/03/2018
Last updated
12/05/2018
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