Provider Demographics
NPI:1336510874
Name:TATAS FOR NOW
Entity Type:Organization
Organization Name:TATAS FOR NOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:HILLIARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-574-1359
Mailing Address - Street 1:2319 W GORE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6301
Mailing Address - Country:US
Mailing Address - Phone:580-699-8846
Mailing Address - Fax:
Practice Address - Street 1:2319 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6301
Practice Address - Country:US
Practice Address - Phone:580-699-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier