Provider Demographics
NPI:1477325090
Name:MCGLASSON, TOMMY LEE
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:LEE
Last Name:MCGLASSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7308 E LOUISVILLE ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-2874
Mailing Address - Country:US
Mailing Address - Phone:918-955-9100
Mailing Address - Fax:
Practice Address - Street 1:7308 E LOUISVILLE ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-2874
Practice Address - Country:US
Practice Address - Phone:918-955-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral