Individual
AMANDA LAGRECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13401 N WESTERN AVE, SUITE 407, OKLAHOMA CITY, OK 73114-1408
(405) 252-3494
(405) 252-3498
Mailing address
PO BOX 269064, OKLAHOMA CITY, OK 73126-9064
(405) 231-3857
(405) 272-7977
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
27630
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200305110A
—
OK
05
—
2155231
—
MA
Enumeration date
11/27/2007
Last updated
03/14/2016
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