Provider Demographics
NPI:1073212387
Name:VCG OKLAHOMA LLC
Entity Type:Organization
Organization Name:VCG OKLAHOMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-491-0041
Mailing Address - Street 1:PO BOX 222132
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-2132
Mailing Address - Country:US
Mailing Address - Phone:903-787-7609
Mailing Address - Fax:
Practice Address - Street 1:4520 S HARVARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2900
Practice Address - Country:US
Practice Address - Phone:918-508-7333
Practice Address - Fax:918-551-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health