Healthcare Provider Details

I. General information

NPI: 1346190865
Provider Name (Legal Business Name): EYECARE ASSOCIATES OF SOUTH TULSA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12140 S WACO AVE
GLENPOOL OK
74033-5660
US

IV. Provider business mailing address

835 N CASS ST
WABASH IN
46992-1613
US

V. Phone/Fax

Practice location:
  • Phone: 918-296-3937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL W LANGLEY
Title or Position: PHYSICIAN
Credential: DO
Phone: 918-250-2020