Provider Demographics
NPI:1649587007
Name:PYLE, TARA MCGAHAN (PHD)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:MCGAHAN
Last Name:PYLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6655 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3326
Practice Address - Country:US
Practice Address - Phone:918-491-3700
Practice Address - Fax:918-481-4063
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2020-04-21
Deactivation Date:2011-06-21
Deactivation Code:
Reactivation Date:2012-02-16
Provider Licenses
StateLicense IDTaxonomies
OK1186103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200516470AMedicaid