MEDICARE: OLYMPIA NEUROLOGICAL INSTITUTE PLLC

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	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1699627661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLYMPIA NEUROLOGICAL INSTITUTE PLLC

Provider Business Mailing Address
First Line	:	6130 E 81ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-2125
Country	:	US
Telephone Number	:	918-401-1002
Fax Number	:	918-493-3304

Provider Business Practice Location Address
First Line	:	1502 BLUE RIDGE DR STE 301
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-1002
Country	:	US
Telephone Number	:	512-409-9903
Fax Number	:	918-493-3304

Authorized Official
Title or Position	:	PHYSICIAN RELATIONS DIRECTOR
Name	:	TYESHA MOSQUITO
Credential	:
Telephone Number	:	918-519-4090

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

Similar Medicare Providers

1407707979 — CAITLYN REANN COTTRELL OTD, OTR
Practice Location Address:

1502 BLUE RIDGE DR STE 200
GEORGETOWN, TX
78626-1002

Practice Phone: 737-738-7768
Practice Fax:

1508849696 — DANIEL JAMES LEEMAN M.D.
Practice Location Address:

1502 BLUE RIDGE DR STE 201
GEORGETOWN, TX
78626-1002

Practice Phone: 512-478-2273
Practice Fax: 512-472-0921

1073587929 — DR. ERIK JUDE BRUCE MD
Practice Location Address:

1502 BLUE RIDGE DR STE 201
GEORGETOWN, TX
78626-1002

Practice Phone: 512-388-2663
Practice Fax: 737-243-8603

1972656908 — DR. CLINTON JOHN BAIRD M.D.
Practice Location Address:

1502 BLUE RIDGE DR STE 301
GEORGETOWN, TX
78626-1002

Practice Phone: 512-409-9903
Practice Fax:

1669606414 — DR. BRENT S WOOD D.P.M.
Practice Location Address:

1502 BLUE RIDGE DR STE 104
GEORGETOWN, TX
78626-1002

Practice Phone: 512-719-4545
Practice Fax: 512-372-3396

1437403821 — BRENT S WOOD DPM PLLC
Practice Location Address:

1502 BLUE RIDGE DR STE 104
GEORGETOWN, TX
78626-1002

Practice Phone: 512-719-4545
Practice Fax: 512-372-3396

Directions to “OLYMPIA NEUROLOGICAL INSTITUTE PLLC ” 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.