Individual
DANIEL E WILDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
717 S HOUSTON AVE STE 400, TULSA, OK 74127-9007
(918) 582-7711
(918) 583-5831
Mailing address
5310 E 31ST ST STE 13, TULSA, OK 74135-5013
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4168
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200031260B
—
OK
01
—
456078YM2Y
MEDICARE
OK
Enumeration date
04/12/2006
Last updated
01/29/2025
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