Healthcare Provider Details

I. General information

NPI: 1336304187
Provider Name (Legal Business Name): NEUROLINKS OF TULSA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 S UTICA AVE SUITE 901
TULSA OK
74104-4000
US

IV. Provider business mailing address

1145 S UTICA AVE SUITE 901
TULSA OK
74104-4000
US

V. Phone/Fax

Practice location:
  • Phone: 918-742-0400
  • Fax:
Mailing address:
  • Phone: 918-742-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number1034
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD BRADLEY VINSON
Title or Position: CEO
Credential: CNIM
Phone: 479-713-0078