Provider Demographics
NPI:1942327747
Name:NOVELO, JULIO OCTAVIO (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:OCTAVIO
Last Name:NOVELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1725 E 19TH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5437
Mailing Address - Country:US
Mailing Address - Phone:918-748-8384
Mailing Address - Fax:918-748-8397
Practice Address - Street 1:1725 E 19TH ST
Practice Address - Street 2:STE 200
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5437
Practice Address - Country:US
Practice Address - Phone:918-748-8384
Practice Address - Fax:918-748-8397
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME98213207R00000X
OK29709207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine