Provider Demographics
NPI:1922280965
Name:SUCCESS VISION EXPRESS OF TULSA, LLC
Entity Type:Organization
Organization Name:SUCCESS VISION EXPRESS OF TULSA, LLC
Other - Org Name:DR. PRESLEY AND ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVYDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-800-2020
Mailing Address - Street 1:7472 E ADMIRAL PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-7913
Mailing Address - Country:US
Mailing Address - Phone:918-794-9029
Mailing Address - Fax:
Practice Address - Street 1:7472 E ADMIRAL PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74115-7913
Practice Address - Country:US
Practice Address - Phone:918-834-2929
Practice Address - Fax:918-834-4005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUCCESS VISION EXPRESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-01
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2049152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty