Provider Demographics
NPI:1356506430
Name:BEARTRACK, CHRISTINA (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:BEARTRACK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:LEE
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3906 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-3131
Mailing Address - Country:US
Mailing Address - Phone:918-585-1523
Mailing Address - Fax:918-587-2706
Practice Address - Street 1:3906 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-3131
Practice Address - Country:US
Practice Address - Phone:918-585-1523
Practice Address - Fax:918-587-2706
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2591152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist