Provider Demographics
NPI:1508430158
Name:ZAPATA RINCON, CRISTIAN ANDRES
Entity Type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:ANDRES
Last Name:ZAPATA RINCON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 E 15TH ST STE 119
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4643
Mailing Address - Country:US
Mailing Address - Phone:539-222-7533
Mailing Address - Fax:
Practice Address - Street 1:2510 E 15TH ST STE 119
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4643
Practice Address - Country:US
Practice Address - Phone:539-222-7533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical