Individual
KATIE DOAN TIENABESO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2800 NW 36TH ST, OKLAHOMA CITY, OK 73112-7477
(405) 943-2020
Mailing address
1 NE 2ND ST APT 404, OKLAHOMA CITY, OK 73104-2236
(405) 625-7999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3259
OK
152WP0200X
Pediatric Optometrist
3259
OK
152WV0400X
Vision Therapy Optometrist
3259
OK
Other
Enumeration date
07/16/2024
Last updated
08/19/2024
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