Provider Demographics
NPI:1033298112
Name:INGELS, TANYA (OD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:INGELS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 W ROBINSON ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3657
Mailing Address - Country:US
Mailing Address - Phone:405-447-5001
Mailing Address - Fax:405-447-4680
Practice Address - Street 1:3720 W ROBINSON ST
Practice Address - Street 2:SUITE 118
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3657
Practice Address - Country:US
Practice Address - Phone:405-447-5001
Practice Address - Fax:405-447-4680
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2234152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist