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General NPI Number Information
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NPI Number | 1255619771
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE COOPER O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2011
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 2424 E 21ST ST STE 200
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City | TULSA
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State | OK
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Zip | 74114-1736
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Country | US
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Telephone | 918-949-4577
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Fax | 918-949-3785
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Provider Business Mailing Address
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Address Line | 2424 E 21ST ST STE 200
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City | TULSA
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State | OK
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Zip | 74114-1736
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Country | US
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Telephone | 918-949-4577
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Fax | 918-949-3785
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2691
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License Number State | OK
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