Basic Information
| Provider Information | |||||||||
| NPI: | 1831332956 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VIVIAN VIERA, MD, PLC | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 900 N PORTER AVE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730716425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053104422 | ||||||||
| FaxNumber: | 4053104424 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 N PORTER AVE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730716425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053104422 | ||||||||
| FaxNumber: | 4053104424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2009 | ||||||||
| LastUpdateDate: | 03/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | VIERA | ||||||||
| AuthorizedOfficialFirstName: | VIVIAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4053104422 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 173000000X | 18676 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Legal Medicine |
No ID Information.