Organization
TRIAD SURGERY CENTER LLC
Active
Other names
Triad Eye Medical Clinic and Cataract Institute PLLC, Triad Eye Institute PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN PATRICK CONLEY (OWNER/MANAGER)
(918) 687-6600
Entity
Organization
Contact information
Practice address
6140 S MEMORIAL DR, TULSA, OK 74133-1933
(918) 252-2020
(918) 252-7466
Mailing address
6140 S MEMORIAL DR, TULSA, OK 74133-1933
(918) 252-2020
(918) 252-7466
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0028
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100738620A
—
OK
01
—
4900008330
MEDICARE ID
OK
01
—
CO5028
RMEDICARE ID
OK
Enumeration date
06/28/2005
Last updated
06/26/2019
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