MEDICARE: EYECARE ASSOCIATES OF SOUTH TULSA PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1720933906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYECARE ASSOCIATES OF SOUTH TULSA PC

Provider Business Mailing Address
First Line	:	10010 E 81ST ST STE 100
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-4558
Country	:	US
Telephone Number	:	918-520-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 CREEK PL
Second Line	:
City	:	OKMULGEE
State	:	OK
Zip	:	74447-6730
Country	:	US
Telephone Number	:	918-756-0316
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DANIEL W LANGLEY
Credential	:	DO
Telephone Number	:	918-250-2020

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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