Provider Demographics
NPI:1811071400
Name:SROUJI, NABIL ELIAS (MD)
Entity type:Individual
Prefix:
First Name:NABIL
Middle Name:ELIAS
Last Name:SROUJI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 NW 58TH ST STE A100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4407
Mailing Address - Country:US
Mailing Address - Phone:405-443-3350
Mailing Address - Fax:405-443-3341
Practice Address - Street 1:3520 NW 58TH ST STE A100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4407
Practice Address - Country:US
Practice Address - Phone:405-443-3350
Practice Address - Fax:405-443-3341
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17285207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2415060002OtherCIGNA
5652035OtherAETNA
743149856OtherUNITED HEALTHCARE
VP11765OtherBLUE LINCS
OK100137580AMedicaid
VP11765OtherBLUE LINCS
2415060002OtherCIGNA