Basic Information
| Provider Information | |||||||||
| NPI: | 1518007848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAHMOORESZADEH | ||||||||
| FirstName: | HOOMAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1011 E 67TH ST | ||||||||
| Address2: | APT# 1012 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741363767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9184936163 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1111 S SAINT LOUIS AVE | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741205440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186194600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2007 | ||||||||
| LastUpdateDate: | 11/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25117 | OK | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.