Individual
NTXHEES VAHCHUAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6200
Mailing address
11523 E 17TH PL, TULSA, OK 74128-5615
(479) 544-5467
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19350
OK
Other
Enumeration date
12/02/2021
Last updated
12/01/2022
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