Individual
DR. KYLE NICHOLAS TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10010 E 81ST ST, STE 100, TULSA, OK 74133-4556
(918) 250-2020
Mailing address
10010 E 81ST ST, STE 100, TULSA, OK 74133-4556
(918) 250-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2715
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2715
STATE OPTOMETRIC PHYSICIAN LICENSE
OK
Enumeration date
07/27/2011
Last updated
07/27/2011
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