Provider Demographics
NPI:1598152191
Name:QUIROZ, GRISEL YULIANA (DO)
Entity Type:Individual
Prefix:MRS
First Name:GRISEL
Middle Name:YULIANA
Last Name:QUIROZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1705 E 19TH ST
Mailing Address - Street 2:STE 302
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5410
Mailing Address - Country:US
Mailing Address - Phone:918-748-7585
Mailing Address - Fax:918-403-6352
Practice Address - Street 1:1705 E 19TH ST
Practice Address - Street 2:STE 302
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5410
Practice Address - Country:US
Practice Address - Phone:918-748-7585
Practice Address - Fax:918-403-6352
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6040207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine