Individual
CARLOS BAUTISTA ENRIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 S TUCKER DR, TULSA, OK 74104-9700
(918) 631-2000
Mailing address
6125 E 106TH PL, TULSA, OK 74137-7005
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
OK
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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