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Individual

SHAW M TANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
802 S JACKSON AVE STE 310, TULSA, OK 74127-9057
(918) 631-8130
(918) 631-8134
Mailing address
802 S JACKSON AVE STE 310, TULSA, OK 74127-9057
(918) 631-8130
(918) 631-8134

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
6508
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200785150A
OK
01
691847
MEDICARE
OK
Enumeration date
04/03/2007
Last updated
02/12/2019
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