Healthcare Provider Details

I. General information

NPI: 1508055963
Provider Name (Legal Business Name): TERRY L LAWSON MS OD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 05/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9102 S TOLEDO AVE SUITE A
TULSA OK
74137-2706
US

IV. Provider business mailing address

9102 S TOLEDO AVE SUITE A
TULSA OK
74137-2706
US

V. Phone/Fax

Practice location:
  • Phone: 918-742-2055
  • Fax:
Mailing address:
  • Phone: 918-742-2055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number1165
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number1165
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number1165
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number1165
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number1165
License Number StateOK
# 6
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number1165
License Number StateOK
# 7
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1167
License Number StateOK
# 8
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2381
License Number StateOK
# 9
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number2381
License Number StateOK
# 10
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number2381
License Number StateOK
# 11
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number2381
License Number StateOK
# 12
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number2381
License Number StateOK
# 13
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number2381
License Number StateOK
# 14
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number2381
License Number StateOK
# 15
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1165
License Number StateOK

VIII. Authorized Official

Name: DR. TERRY LARMON LAWSON
Title or Position: MANAGER
Credential: O.D.
Phone: 918-742-2055