LUIS ENRIQUE DIEZ AVILA

OKLAHOMA CITY, OK
NPI1427740075
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: OK  5020)
Additional Taxonomies363AM0700X Physician Assistant, Medical
(Licence: SC  5562)
Enumeration Date2023-05-23
Last Update Date2025-05-07
Business Address
LUIS ENRIQUE DIEZ AVILA PA-C
4021 S WALKER AVE STE 201
OKLAHOMA CITY, OK 73109-6977
Phone number: 405-632-6688
Mailing Address
LUIS ENRIQUE DIEZ AVILA PA-C
3000 N GRAND BLVD
OKLAHOMA CITY, OK 73107-1818
Phone number: 405-632-6688