DR. CARLOS GOMEZ-MEADE (NPI# 1023235579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023235579 |
| Entity Type | Individual |
| Full Name | DR. CARLOS GOMEZ-MEADE |
| Credential | D.O. |
| Practice Address |
800 W. Boise Circle, Suite 400 Broken Arrow OK 74012 |
| Practice Telephone | 9183070215 |
| Practice Fax Number | 9182507669 |
| Mailing Telephone | 9183070215 |
| Mailing Fax Number | 9182507669 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | P0829 | TX | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
6596 | OK | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
P0829 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 302669201 | 05 |
| Street Address |
800 W. BOISE CIRCLE, SUITE 400 |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104291236 | Oklahoma Cancer Specialists and Research Institute LLC | Dermatology | 800 W Boise Cir Ste 400, Broken Arrow, OK 74012-4974 | 2015-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750466934 | Advanced Dermatology, Inc | Dermatology | 1030 E Washington Ave, Mcalester, OK 74501-4850 | 2006-10-26 |
| 1285647586 | Scott William Meyers | Dermatology | 1440 Terrace Dr, Tulsa, OK 74104-4626 | 2006-08-15 |
| 1124038518 | Mary Margaret Christian-reed | Dermatology | 9306 S Toledo Ct, Suite #100, Tulsa, OK 74137-2746 | 2006-08-08 |
| 1962061440 | Skin Cancer Center, Pllc | Dermatology | 2404 Palmer Cir, Norman, OK 73069-6301 | 2019-06-10 |
| 1023378759 | Robert Fischer | Dermatology | 5801 E 41st St Ste 200, Tulsa, OK 74135-5627 | 2012-05-29 |
| 1831349281 | Susannah L Collier Md Pllc | Dermatology | 3705 W Memorial Rd, Suite 101, Oklahoma City, OK 73134-1512 | 2008-09-23 |
| 1942335773 | Dermatology and Laser Center of Oklahoma | Dermatology | 9306 S Toledo Ct, Suite #100, Tulsa, OK 74137-2746 | 2007-02-22 |
| 1932286069 | Oklahoma Skin Surgery & Cosmetic Dermatology, P.C. | Dermatology | 1440 Terrace Dr, Tulsa, OK 74104-4626 | 2006-11-01 |
| 1598776866 | James B. Stewart, Jr., M.d., P.C. | Dermatology | 3705 W Memorial Rd, Suite 101, Oklahoma City, OK 73134-1512 | 2006-08-11 |
| City | BROKEN ARROW |
| Zip Code | 74012 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.