MEDICARE: EAGLE PARTNERS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2085R0001X	Radiation Oncology Physician
2	2085B0100X	Body Imaging Physician
3	2085D0003X	Diagnostic Neuroimaging (Radiology) Physician
4	2085N0700X	Neuroradiology Physician
5	2085N0904X	Nuclear Radiology Physician
6	2085P0229X	Pediatric Radiology Physician
7	2085R0204X	Vascular & Interventional Radiology Physician
8	2085U0001X	Diagnostic Ultrasound Physician
9	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1548450976	OTHER	OK	BLUE CROSS OKLAHOMA

General Provider Information

NPI Number	:	1548450976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE PARTNERS, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 205193
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-5193
Country	:	US
Telephone Number	:	405-334-5226
Fax Number	:

Provider Business Practice Location Address
First Line	:	2621 N WHISENANT DR
Second Line	:
City	:	DUNCAN
State	:	OK
Zip	:	73533
Country	:	US
Telephone Number	:	580-252-5300
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	SHARLEE LEBLEU
Credential	:
Telephone Number	:	480-321-7026

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	07/12/2024

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Directions to “EAGLE PARTNERS, PLLC ” Practice Location

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