Individual
DR. VISHAL MUNDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Contact information
Practice address
1705 E 19TH ST, STE 302, TULSA, OK 74104-5405
(918) 748-7599
(918) 748-7539
Mailing address
1515 N HARVARD AVE, STE E, TULSA, OK 74115-4957
(918) 832-6049
(918) 832-6055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28366
OK
207R00000X
Internal Medicine Physician
TRN12648
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28366
OK ST LICENSE
OK
Enumeration date
01/08/2010
Last updated
06/03/2011
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