Provider Demographics
NPI:1750090064
Name:SOUTHWEST ORTHOPAEDIC SPECIALISTS, PLLC
Entity type:Organization
Organization Name:SOUTHWEST ORTHOPAEDIC SPECIALISTS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:STREICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-619-4410
Mailing Address - Street 1:8100 S WALKER AVE BLDG A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-9475
Mailing Address - Country:US
Mailing Address - Phone:405-632-4468
Mailing Address - Fax:405-632-0436
Practice Address - Street 1:401 SW 80TH ST BLDG. D
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-8123
Practice Address - Country:US
Practice Address - Phone:405-619-4470
Practice Address - Fax:405-900-5363
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST ORTHOPAEDIC SPECIALISTS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-16
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty