Individual
DR. POORYA FAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6151 S YALE AVE, SUITE A-100, TULSA, OK 74136-1907
(918) 494-8500
(918) 307-5578
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
(918) 488-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N2495
TX
207RI0011X
Interventional Cardiology Physician
Primary
30464
OK
390200000X
Student in an Organized Health Care Education/Training Program
AA22180774308
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207296902
—
TX
Enumeration date
05/18/2007
Last updated
06/13/2019
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