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General NPI Number Information
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NPI Number | 1750475760
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Entity Type | Organization
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Legal Business Name | EYECARE ASSOCIATES OF SOUTH TULSA PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 10010 E 81ST ST STE 100
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City | TULSA
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State | OK
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Zip | 74133-4558
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Country | US
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Telephone | 918-250-2020
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Fax | 918-250-8910
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Provider Business Mailing Address
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Address Line | 10010 E 81ST ST STE 100
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City | TULSA
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State | OK
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Zip | 74133-4558
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Country | US
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Telephone | 918-250-2020
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Fax | 918-250-8910
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | KRISTY PHILLIPS
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Credential |
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Telephone | 918-250-2020
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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 | 2147
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4088
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License Number State | OK
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