MEDICARE: EYECARE ASSOCIATES OF SOUTH TULSA PC

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

General Provider Information

NPI Number	:	1689524100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYECARE ASSOCIATES OF SOUTH TULSA PC

Provider Business Mailing Address
First Line	:	835 N CASS ST
Second Line	:
City	:	WABASH
State	:	IN
Zip	:	46992-1613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11880 E 86TH ST N
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-2535
Country	:	US
Telephone Number	:	918-272-3937
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DANIEL W LANGLEY
Credential	:	DO
Telephone Number	:	918-250-2020

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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