Provider Demographics
NPI:1053405951
Name:JUSTIZ, ALINA C (MD)
Entity type:Individual
Prefix:DR
First Name:ALINA
Middle Name:C
Last Name:JUSTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALINA
Other - Middle Name:
Other - Last Name:JUSTIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1215 CROSSROADS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3334
Mailing Address - Country:US
Mailing Address - Phone:405-606-8920
Mailing Address - Fax:405-310-6720
Practice Address - Street 1:1215 CROSSROADS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3334
Practice Address - Country:US
Practice Address - Phone:405-606-8920
Practice Address - Fax:405-310-6720
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2358207L00000X
OK27481207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147562101Medicaid
TX8M0722OtherBC/BS
TX147562100OtherFIRSTCARE COMMERCIAL
OK200072520AMedicaid
TX8M0736OtherHMO BLUE
OK200495300AMedicaid
NM202003982Medicaid
TX179159201Medicaid
NM202003982OtherPRESBYTERIAN COMMERCIAL
NM50407881Medicaid
OK200495300AMedicaid