Provider Demographics
NPI:1609099696
Name:TRACY T TRAN OD PC
Entity Type:Organization
Organization Name:TRACY T TRAN OD PC
Other - Org Name:ARROW EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:T
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:918-455-0222
Mailing Address - Street 1:749 W NEW ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-1812
Mailing Address - Country:US
Mailing Address - Phone:918-455-0222
Mailing Address - Fax:918-455-0226
Practice Address - Street 1:749 W NEW ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74011-1812
Practice Address - Country:US
Practice Address - Phone:918-455-0222
Practice Address - Fax:918-455-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2262152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty