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Individual

ROBERT VILLAREAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2950 S ELM PL, SUITE 160, BROKEN ARROW, OK 74012-7877
(918) 449-3750
(918) 449-3755
Mailing address
6600 S YALE AVE, STE 1400, TULSA, OK 74136-3310

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23592
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200012750A
OK
Enumeration date
03/14/2006
Last updated
09/29/2022
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