Healthcare Provider Details

I. General information

NPI: 1255471629
Provider Name (Legal Business Name): TULSA EYE ASSOCIATES OPTICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6465 S YALE AVE SUITE 210
TULSA OK
74136-7823
US

IV. Provider business mailing address

6465 S YALE AVE SUITE 210
TULSA OK
74136-7823
US

V. Phone/Fax

Practice location:
  • Phone: 918-493-7337
  • Fax: 918-494-0700
Mailing address:
  • Phone: 918-493-7337
  • Fax: 918-494-0700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: JAMES FREDERICK RONK
Title or Position: PRESIDENT
Credential: M.D.
Phone: 918-493-7337