MEDICARE: DR. LARA MAE MATTOX PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	06-09P	AR
2	103TC0700X	Clinical Psychologist	1022	OK

General Provider Information

NPI Number	:	1073626545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARA MAE MATTOX PH.D.

Provider Business Mailing Address
First Line	:	3015 EAST SKELLY DRIVE
Second Line	:	SUITE 305
City	:	TULSA
State	:	OK
Zip	:	74105-6317
Country	:	US
Telephone Number	:	918-392-4866
Fax Number	:	918-392-4867

Provider Business Practice Location Address
First Line	:	3015 EAST SKELLY DRIVE
Second Line	:	SUITE 305
City	:	TULSA
State	:	OK
Zip	:	74105-6317
Country	:	US
Telephone Number	:	918-392-4866
Fax Number	:	918-392-4867

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	11/03/2011

Similar Medicare Providers

1427065259 — MS. LAURA L. SAVAGE M.S., LPC, LADC
Practice Location Address:

3015 E SKELLY DR STE 1295
TULSA, OK
74105-6317

Practice Phone: 918-606-3656
Practice Fax:

1205821022 — DR. MANJU KAUL PHD
Practice Location Address:

3015 E SKELLY DR , SUITE 135
TULSA, OK
74105-6317

Practice Phone: 918-712-2885
Practice Fax: 918-712-9019

1215922042 — ADAM G SHERMAN PHD PC
Practice Location Address:

3015 E SKELLY DR , SUITE 135
TULSA, OK
74105-6317

Practice Phone: 918-712-2885
Practice Fax: 918-712-9019

1811095284 — SUSAN E TEAGUE L.P.C.
Practice Location Address:

3015 E SKELLY DR , SUITE 390
TULSA, OK
74105-6317

Practice Phone: 918-665-0208
Practice Fax: 918-665-0216

1003914367 — LAUREL DIANE SMITH
Practice Location Address:

3015 E SKELLY DR , SUITE 390
TULSA, OK
74105-6317

Practice Phone: 918-665-0208
Practice Fax: 918-665-0216

1619075967 — MICHAL MAYBELLO ABUTBUL MHR
Practice Location Address:

3015 E SKELLY DR , SUITE 390
TULSA, OK
74105-6317

Practice Phone: 918-665-0208
Practice Fax: 918-665-0216

Directions to “ DR. LARA MAE MATTOX PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.