Anibal Avila MD Professional Corporation PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

18774 Issued in OK

Legal business name

ANIBAL AVILA MD PROFESSIONAL CORPORATION PC

Practice address

1111 SW 44TH St
Oklahoma City, OK 73109-3601

Phone

(405) 634-4934

Fax

(405) 634-4938

NPI assigned

May 11, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anibal Avila, MDNPI 1649213513

Title

Owner

Phone

(405) 634-4934

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anibal Avila, M.D.

  • Internal Medicine Physician
  • Oklahoma City, OK
  • NPI 1649213513
  Medicare reassignment Care Compare group NPD Authorized official
• Susana Jimenez, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Edmond, OK
  • NPI 1558136549
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1578855409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SW 44TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093601",
            "telephone_number": "405-634-4934",
            "fax_number": "405-634-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SW 44TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093601",
            "telephone_number": "405-634-4934",
            "fax_number": "405-634-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANIBAL AVILA MD PROFESSIONAL CORPORATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "ANIBAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-634-4934",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "18774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Angles, MD
• Tyronnie Lakay Anglin-Williams
• Cole Anglin
• John Robert Anglin, PA-C
• Trenna Renee Anguiano, MCP IN PSYCHOLOGY
• Jackie Aniebok
• Olawale Animashaun
• Paul Anjembe
• Anjum Rukhsana PC
• Anna Craycraft PHD PLLC

• Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.