Provider Demographics
NPI:1588643621
Name:STRAFACE, ANGELA LEA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LEA
Last Name:STRAFACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 960046
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0046
Mailing Address - Country:US
Mailing Address - Phone:800-684-0094
Mailing Address - Fax:405-844-1794
Practice Address - Street 1:1600 HOSPITAL PKWY
Practice Address - Street 2:ER DEPT
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6913
Practice Address - Country:US
Practice Address - Phone:817-354-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8500207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105103903Medicaid
TX1588643621OtherTRICARE SOUTH
TX86797NOtherBCBS
TX105103901Medicaid
TX105103905Medicaid
TX8EG519OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX105103910Medicaid
TX105103912Medicaid
TX8U6949OtherBCBS
TX930081901OtherMEDICARE RAILROAD
TXG42793Medicare UPIN
TX105103901Medicaid
TX105103905Medicaid
TX274949ZG6FMedicare PIN
TX1588643621OtherTRICARE SOUTH
TX86797NOtherBCBS