Individual
JUAN LASES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 NW 58 ST, OK CITY, OK 73112
(405) 942-4783
(405) 942-3471
Mailing address
3535 NW 58 ST, STE 768, OK CITY, OK 73112
(405) 942-4783
(405) 942-3471
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10828
OK
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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