Individual
MR. CARLOS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 502-1900
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
(918) 488-6001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2618
OK
363AM0700X
Medical Physician Assistant
005095
GA
Other
Enumeration date
06/25/2007
Last updated
02/22/2017
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