Provider Demographics
NPI:1235574385
Name:ESTRADA, NETZA JAVIER (PRSS)
Entity Type:Individual
Prefix:MR
First Name:NETZA
Middle Name:JAVIER
Last Name:ESTRADA
Suffix:
Gender:M
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S VICTOR AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-2205
Mailing Address - Country:US
Mailing Address - Phone:918-813-1125
Mailing Address - Fax:
Practice Address - Street 1:315 S VICTOR AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-2205
Practice Address - Country:US
Practice Address - Phone:918-813-1125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst