Individual
REYNALDO DE LOS ANGELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-5473
Mailing address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12127
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12127
STATE BOARD OF PHARMACY
OK
Enumeration date
12/19/2014
Last updated
12/19/2014
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