Individual
MIGUEL ROMEL GAVIN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 E APACHE ST, TULSA, OK 74106-3702
(918) 810-0275
Mailing address
231 E APACHE ST, TULSA, OK 74106-3701
(918) 810-0275
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
G083673012
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N00001838-02
COMMUNITY CARE
OK
Enumeration date
12/17/2021
Last updated
12/17/2021
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