Matthew Louis Azcona
Individual provider Active NPI Counselor · Oklahoma City, OK
NPI 1154600872 · NPPES record last updated Aug 11, 2011
Key facts
- NPI
- 1154600872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1140 N Hudson Ave
Oklahoma City, OK 73103-3918 - Phone
- (405) 858-2924
- NPI assigned
- Aug 11, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1140 N Hudson Ave
Oklahoma City, OK 73103-3918
Mailing address
4436 NW 50TH St
Oklahoma City, OK 73112-2212
Phone (405) 858-2700
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.