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GWEN FUENTES MD PEDIATRIC CLINIC
NPI 1083830608
Clinic/Center - Medical Specialty in Ardmore, OK

Active since April 18, 2007
919 15TH AVE NW, ARDMORE, OK 73401(580) 223-5693(580) 223-8909 Get Directions Write a Review

NPPES record last updated: January 30, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Gwen Fuentes Md Pediatric Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GWEN FUENTES MD PEDIATRIC CLINIC (NPI 1083830608) is a healthcare organization registered as a medical specialty in Ardmore, Oklahoma and active in the NPI registry since April 2007. The organization lists Gwen Canarias Fuentes, Owner, as its authorized official.

NPPES Registry Identity

NPI1083830608
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameGWEN FUENTES MD PEDIATRIC CLINIC
Location Address919 15TH AVE NWArdmore, OK 73401-1809
Mailing Address919 15th Ave NwArdmore, OK 73401-1809 · (580) 223-5693 · Fax (580) 223-8909
Phone(580) 223-5693
Fax(580) 223-8909
Organization SubpartNo
Authorized OfficialGwen Canarias FuentesOwner · (580) 223-5693
Enumeration DateApril 18, 2007
Last NPPES UpdateJanuary 30, 2011
✔ NPI 1083830608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in OK · 13171
Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Also ListedPediatricsTaxonomy 208000000X · License 13171 (OK)
919 15TH AVE NW, Ardmore, OK 73401
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Other Identifiers 3

Medicaid100209330AOK
Medicare UPINF24254OK
Medicaid100209330COK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GWEN CANARIAS FUENTES M.D.
Pediatrics
919 15TH AVE NW
ARDMORE, OK 73401
Carter County (580) 223-5693

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gwen Fuentes MD Pediatric Clinic's NPI number?

The NPI number for Gwen Fuentes MD Pediatric Clinic is 1083830608. It was assigned to this organization in the NPPES registry on April 18, 2007.

Where is Gwen Fuentes MD Pediatric Clinic located?

Gwen Fuentes MD Pediatric Clinic is located at 919 15th Ave NW, Ardmore, OK 73401. The listed phone number is (580) 223-5693.

What is Gwen Fuentes MD Pediatric Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Gwen Fuentes MD Pediatric Clinic was last updated on January 30, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.