Provider Demographics
NPI:1831249812
Name:AGARWAL, PALLAVI (MD)
Entity type:Individual
Prefix:DR
First Name:PALLAVI
Middle Name:
Last Name:AGARWAL
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 1:3336 E 32 STREET
Mailing Address - Street 2:200
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-4448
Mailing Address - Country:US
Mailing Address - Phone:918-742-4900
Mailing Address - Fax:918-742-4901
Practice Address - Street 1:3336 E 32ND ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-4448
Practice Address - Country:US
Practice Address - Phone:918-742-4900
Practice Address - Fax:918-742-4901
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23998207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200129830BMedicaid
OK200129830BMedicaid