Individual
MRS. LAURA ELISE JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1265 S UTICA AVE STE 105, TULSA, OK 74104-4243
(918) 592-0999
(918) 592-1021
Mailing address
PO BOX 615, DORADO, PR 00646-0615
(801) 362-6791
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
000919
PR
363AM0700X
Medical Physician Assistant
—
UT
363AS0400X
Surgical Physician Assistant
4749
OK
363AS0400X
Surgical Physician Assistant
Primary
56826
CA
Other
Enumeration date
11/04/2016
Last updated
01/10/2025
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