Provider Demographics
NPI:1326345091
Name:POPPELAARS, VICTORIA H (PA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:H
Last Name:POPPELAARS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:H
Other - Last Name:ACOSTA-MUSALEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4500 S GARNETT RD
Mailing Address - Street 2:STE 300
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5229
Mailing Address - Country:US
Mailing Address - Phone:918-664-9892
Mailing Address - Fax:918-664-2521
Practice Address - Street 1:4000 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1202
Practice Address - Country:US
Practice Address - Phone:713-359-2273
Practice Address - Fax:918-664-2521
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant