MEDICARE: SUCCESS VISION EXPRESS OF SAND SPRINGS, LLC

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	152W00000X	Optometrist	2049	OK

General Provider Information

NPI Number	:	1346424637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUCCESS VISION EXPRESS OF SAND SPRINGS, LLC

Provider Business Mailing Address
First Line	:	7472 E ADMIRAL PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74115
Country	:	US
Telephone Number	:	918-794-9029
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 S HIGHWAY 97 STE B
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-6571
Country	:	US
Telephone Number	:	918-241-2020
Fax Number	:	918-241-0215

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD I PRESLEY
Credential	:
Telephone Number	:	539-476-2015

Provider Enumeration Date	:	12/21/2007
Last Update Date	:	05/19/2026

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