Healthcare Provider Details

I. General information

NPI: 1700632148
Provider Name (Legal Business Name): CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 E 71ST ST STE 100
TULSA OK
74136-5036
US

IV. Provider business mailing address

1323 E 71ST ST STE 100
TULSA OK
74136-5036
US

V. Phone/Fax

Practice location:
  • Phone: 918-492-2554
  • Fax:
Mailing address:
  • Phone: 918-492-2554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE TAYLOR
Title or Position: BILLING/CREDENTIALING SUPERVISOR
Credential:
Phone: 918-935-2551