Provider Demographics
NPI:1336304187
Name:NEUROLINKS OF TULSA, LLC
Entity Type:Organization
Organization Name:NEUROLINKS OF TULSA, LLC
Other - Org Name:NEUROLINKS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:479-713-0078
Mailing Address - Street 1:1145 S UTICA AVE
Mailing Address - Street 2:SUITE 901
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4000
Mailing Address - Country:US
Mailing Address - Phone:918-742-0400
Mailing Address - Fax:
Practice Address - Street 1:1145 S UTICA AVE
Practice Address - Street 2:SUITE 901
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4000
Practice Address - Country:US
Practice Address - Phone:918-742-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1034261QM2500X
293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No293D00000XLaboratoriesPhysiological Laboratory