Basic Information
| Provider Information | |||||||||
| NPI: | 1881913895 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILVA PALACIOS | ||||||||
| FirstName: | FEDERICO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 STANTON L YOUNG BLVD # 5400 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052714742 | ||||||||
| FaxNumber: | 4052712619 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 NE 10TH ST # 2E | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052717001 | ||||||||
| FaxNumber: | 4052717034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2010 | ||||||||
| LastUpdateDate: | 12/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | 30712 | OK | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 207R00000X | 30712 | OK | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.