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Next Update: Thursday, December 19, 2024 12:00 PM CST
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RUIDERA, GRACE MATA
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This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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| Practice Address: |
111 N. POST ROAD
SUITE C
MIDWEST CITY OK 73130-3605
Address last updated on 1/10/2023 |
| Phone #: |
(405) 455-4342 |
| Fax #: |
(405) 455-4381 |
| County: |
OKLAHOMA |
| License: |
19279 |
| Dated: |
3/21/1995 |
| Expires: |
3/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Internal Medicine
Nephrology |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
PHILIPPINE MEDICAL SCHOOLS |
| Graduated: |
4 /
1979 |
| CME Year: |
2025 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF INTERNAL MEDICINE |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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