Provider Demographics
NPI:1528225893
Name:AUDIOLOGY OF TULSA, PLLC
Entity Type:Organization
Organization Name:AUDIOLOGY OF TULSA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:918-745-9052
Mailing Address - Street 1:4564 S HARVARD AVE
Mailing Address - Street 2:STE A
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2918
Mailing Address - Country:US
Mailing Address - Phone:918-745-9052
Mailing Address - Fax:918-749-9770
Practice Address - Street 1:4564 S HARVARD AVE
Practice Address - Street 2:STE A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2918
Practice Address - Country:US
Practice Address - Phone:918-745-9052
Practice Address - Fax:918-749-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK00008231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty