Provider Demographics
NPI:1578096376
Name:ANGEL, CURT A (ATP)
Entity Type:Individual
Prefix:
First Name:CURT
Middle Name:A
Last Name:ANGEL
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 S 84TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-8340
Mailing Address - Country:US
Mailing Address - Phone:918-949-5797
Mailing Address - Fax:
Practice Address - Street 1:1706 S 84TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-8340
Practice Address - Country:US
Practice Address - Phone:918-949-5797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-07
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
OK#86759246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment