Fulps Family Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2924 Issued in OK

Legal business name

FULPS FAMILY EYE CARE, LLC

Practice address

3300 S Aspen Ave Ste D
Broken Arrow, OK 74012

Phone

(918) 451-2020

NPI assigned

Apr 18, 2018

Last updated

Aug 3, 2018By 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

Dr. Calen N Fulps, OD

Title

Optometrist

Phone

(918) 812-9327

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1699262386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W MIAMI ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740114842",
            "telephone_number": "918-812-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S ASPEN AVE STE D",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-451-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULPS FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "FULPS",
        "authorized_official_first_name": "CALEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "918-812-9327",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200737030A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; 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.