Edwin Fabian Vazquez

Individual provider Active NPI Social Worker · Oklahoma City, OK

NPI 1942963756 · NPPES record last updated Oct 6, 2022

Key facts

NPI
1942963756
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
8852 (OK)
Practice address
1111 N Lee Ave Ste 207
Oklahoma City, OK 73103-2620
Phone
(405) 516-0343
NPI assigned
Oct 19, 2021
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

State licenses

LicenseStateTypeSpecialty
8852OKMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8852 OK Yes

Addresses

Primary practice location

1111 N Lee Ave Ste 207
Oklahoma City, OK 73103-2620

Mailing address

1111 N Lee Ave Ste 207
Oklahoma City, OK 73103-2620
Phone (405) 516-0343

Other providers in Oklahoma City, OK

All providers in Oklahoma City, OK · Social Worker in Oklahoma

Sources for this page

Verify at the official NPI Registry.