Provider Demographics
NPI:1457523425
Name:BATES, ANDREW LEE (CPT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LEE
Last Name:BATES
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-6916
Mailing Address - Country:US
Mailing Address - Phone:918-955-3118
Mailing Address - Fax:
Practice Address - Street 1:5050 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-6916
Practice Address - Country:US
Practice Address - Phone:918-955-3118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-30
Last Update Date:2008-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL202332171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor