Tulsa Vein Institute PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

3263 Issued in OK

Legal business name

TULSA VEIN INSTITUTE PLLC

Practice address

6901 S Yorktown Ave
Tulsa, OK 74136-3986

Phone

(918) 706-2161

Fax

(918) 701-2021

NPI assigned

Mar 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Davin Haraway, D.O.NPI 1679679062

Title

Practitioner

Phone

(918) 706-2161

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

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

• Glenn Davin Haraway, DO

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1679679062
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1154714673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 S YORKTOWN AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363986",
            "telephone_number": "918-706-2161",
            "fax_number": "918-701-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 S YORKTOWN AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363986",
            "telephone_number": "918-706-2161",
            "fax_number": "918-701-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA VEIN INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "HARAWAY",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "DAVIN",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "918-706-2161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "3263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "405679",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200582270A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tulsa Spine & Specialty Hospital Pharmacy
• Tulsa Spine & Specialty Hospital Pharmacy
• Tulsa Therapy Solutions
• Tulsa Time Dental Design
• Tulsa Varicose Vein Center LLC
• Tulsa Vision Clinic, Inc.
• Tulsa Wellness Management, LLC
• Tulsa Women'S Healthcare, PLLC.
• Tulsa X-Ray Laboratory PLLC
• Tulsa-Amg Specialty Hospital, LLC

• Internal Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.