Individual
LATA KOIRALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1145 S UTICA AVE, SUITE 460, TULSA, OK 74104-4000
(918) 579-5749
Mailing address
1145 S UTICA AVE, STE 460, TULSA, OK 74104-4041
(918) 579-5749
(918) 579-5762
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12108
TX
363AM0700X
Medical Physician Assistant
2483
OK
Other
Enumeration date
01/30/2015
Last updated
05/16/2022
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