Tahlequah Family Vision Clinic, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OK 2111 Issued in OK

Legal business name

TAHLEQUAH FAMILY VISION CLINIC, PLLC

Practice address

681 W Choctaw St
Tahlequah, OK 74464-3711

Phone

(918) 456-2250

Fax

(918) 456-2251

NPI assigned

Jun 14, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Molly Gean Tebow, ODNPI 1811305659

Title

Owner/Optometrist

Phone

(918) 456-2250

Specialties & licenses 1

Addresses

Other names 1

• Tahlequah Family Vision Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Molly Gean Tebow, OD

  • Optometrist
  • Tahlequah, OK
  • NPI 1811305659
  Medicare reassignment Care Compare group NPD Authorized official
• Matthew Endres, OD

  • Optometrist
  • Tahlequah, OK
  • NPI 1700566817
  Medicare reassignment Care Compare group NPD
• Kelsey Buford, OD

  • Optometrist
  • Fort Gibson, OK
  • NPI 1821641267
  Medicare reassignment NPD
• Kelly Glass, OD

  • Optometrist
  • Broken Arrow, OK
  • NPI 1023425675
  Medicare reassignment NPD
• Tory L Dotson, O.D.

  • Optometrist
  • Tahlequah, OK
  • NPI 1790099786
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1033313754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 W CHOCTAW ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643711",
            "telephone_number": "918-456-2250",
            "fax_number": "918-456-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 W CHOCTAW ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643711",
            "telephone_number": "918-456-2250",
            "fax_number": "918-456-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHLEQUAH FAMILY VISION CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "TEBOW",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "GEAN",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "918-456-2250",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK 2111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tahlequah Family Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary Scott Taggart, PA-C
• Tahlequah City Hospital
• Tahlequah Dental Care PLLC
• Tahlequah Drug Company LLC
• Tahlequah Family Medicine Clinic
• Tahlequah Internal Medicine Inc
• Tahlequah Medical Associates
• Tahlequah Medical Group LLC
• Tahlequah Orthopedic Surgery Services, LLC
• Tahlequah Public Schools

• Optometrist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.