| Senior Psychcare Of Oklahoma, Llc | |
|
6202 E 61st St Tulsa OK 74136-2119 | |
| (713) 850-0049 | |
| Not Available |
| Full Name | Senior Psychcare Of Oklahoma, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6202 E 61st St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Randall J. Frapart (COO/CFO) |
| Authorized Official Contact | 7138500049 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Psychcare Of Oklahoma, Llc 4635 Southwest Fwy Ste 635 Houston TX 77027-7112 Ph: (713) 850-0049 | Senior Psychcare Of Oklahoma, Llc 6202 E 61st St Tulsa OK 74136-2119 Ph: (713) 850-0049 |
| NPI Number | 1013668961 |
|---|---|
| Provider Enumeration Date | 01/12/2022 |
| Last Update Date | 01/12/2022 |
| Certification Date | 01/12/2022 |
| Medicare PECOS PAC ID | 9638566839 |
|---|---|
| Medicare Enrollment ID | O20220418000778 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013668961 | NPI | - | NPPES |
| Provider Name | Bradley A Mcclure |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790755916 PECOS PAC ID: 2365478104 Enrollment ID: I20050823000045 |
| Provider Name | Lisa Gale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245646389 PECOS PAC ID: 6608193313 Enrollment ID: I20170711000609 |
| Provider Name | Tandaleo Gamble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578025078 PECOS PAC ID: 3173857281 Enrollment ID: I20190624002511 |
| Provider Name | Julia Fernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760617773 PECOS PAC ID: 2567619950 Enrollment ID: I20220418000934 |
| Provider Name | Victoria Forsberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255831210 PECOS PAC ID: 9830452242 Enrollment ID: I20230321000895 |
| Provider Name | Brenda Kay Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316590714 PECOS PAC ID: 5991162455 Enrollment ID: I20230530000473 |
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