Provider Demographics
NPI:1740211176
Name:CYR, HANS E (OTRL CHT)
Entity Type:Individual
Prefix:MR
First Name:HANS
Middle Name:E
Last Name:CYR
Suffix:
Gender:M
Credentials:OTRL CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 E 53 ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6601
Mailing Address - Country:US
Mailing Address - Phone:918-712-8412
Mailing Address - Fax:918-712-8413
Practice Address - Street 1:2417 E 53 ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6601
Practice Address - Country:US
Practice Address - Phone:918-712-8412
Practice Address - Fax:918-712-8413
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100656130AMedicaid
2979439OtherAETNA
OK248227402Medicare ID - Type Unspecified