Organization
ELITE FAMILY MEDICINE LLC
Active
Organization
ELITE FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VISHAL AGGARWAL MD (MEMBER)
(918) 742-4900
Entity
Organization
Contact information
Practice address
3336 E 32ND ST STE 205, TULSA, OK 74135-4454
(918) 398-0800
(918) 398-0810
Mailing address
3336 E 32ND ST STE 205, TULSA, OK 74135-4454
(918) 398-0800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200749030B
—
OK
Enumeration date
09/18/2017
Last updated
06/10/2020
Update your record
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