South Tulsa ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTH TULSA ASC, LLC

Practice address

9840 E 81St St Ste 200
Tulsa, OK 74133-4584

Phone

(623) 764-2780

NPI assigned

Mar 26, 2019

Last updated

Mar 26, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Terrance Wade O'Neal

Title

Owner/Partner

Phone

(623) 764-2780

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1174084982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20235 N CAVE CREEK RD # 104-472",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850244424",
            "telephone_number": "623-764-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 E 81ST ST STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334584",
            "telephone_number": "623-764-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TULSA ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "O'NEAL",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "623-764-2780",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ziad Sous, MD
• Kayla Soutee, PT
• South Carolina Professional Reading PC
• South Peoria Neighborhood Connection Foundation (South Tulsa Community House)
• South Tulsa Anesthesia LLC
• South Tulsa Family Pracitce Inc
• South Tulsa Imaging, L.L.C. (Imaging Solutions of Tulsa)
• South Tulsa Medical Group LLC
• South Tulsa Open MRI, LLC (Vantage Diagnostic Imaging of Tulsa)
• South Tulsa Optical, Inc.

• Ambulatory Surgical Clinic/Center in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Ambulatory Surgical Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.