Active NPI
Alexandros Mallios, MD
- Vascular Surgery Physician
- Tulsa, OK
National Provider Identifier
1235477613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 29519
- Practice address
- 1919 S Wheeling Ave
Suite 600
Tulsa, OK 74104-5638 - Phone
- (918) 744-3908
- NPI assigned
- Jan 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 29519 | OK | Primary |
Addresses
Primary practice location
1919 S Wheeling Ave
Suite 600
Tulsa, OK 74104-5638
Mailing address
450 W 7TH St
Tulsa, OK 74119-1051
Phone (918) 510-1735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29519 | OK | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358640000000",
"number": "1235477613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 W 7TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741191051",
"telephone_number": "918-510-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 S WHEELING AVE",
"address_2": "SUITE 600",
"city": "TULSA",
"state": "OK",
"postal_code": "741045638",
"telephone_number": "918-744-3908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLIOS",
"first_name": "ALEXANDROS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-20",
"last_updated": "2013-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "OK",
"license": "29519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.