Healthcare Provider Details

I. General information

NPI: 1992630180
Provider Name (Legal Business Name): TRADITIONS HEALTH CARE OF EDMOND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7725 W RENO AVE STE 332
OKLAHOMA CITY OK
73127-9799
US

IV. Provider business mailing address

8150 N CENTRAL EXPY STE 1800
DALLAS TX
75206-1883
US

V. Phone/Fax

Practice location:
  • Phone: 405-688-2120
  • Fax: 405-942-3429
Mailing address:
  • Phone: 469-839-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRIS WALKER
Title or Position: CFO/CAO
Credential:
Phone: 469-839-3706