Pro-Care Family Health of Oklahoma , LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PRO-CARE FAMILY HEALTH OF OKLAHOMA , LLC

Doing business as

Pro-Care Specialty Clinic

Practice address

1013 Dewey Ave
Poteau, OK 74953-4409

Phone

(918) 721-0140

Fax

(918) 647-0460

NPI assigned

May 22, 2026

Organization subpart

Yes

Parent organization

PRO-CARE FAMILY HEALTH OF OKLAHOMA , LLCAs reported in NPPES

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

Authorized official

Name

Evelyn Marie Tustin

Title

Manager

Phone

(918) 649-3777

Specialties & licenses 1

Addresses

Other names 1

• Pro-Care Specialty Clinic Doing business as

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

CLIA laboratory certificates

Tax ID family

Pro-Care Fam HLTH of Ok LLC2 organizations share this tax ID, including this one

Part of

Pro-Care Fam HLTH of Ok LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pro-Care Family Health of Oklahoma , LLC

  • Rural Health Clinic/Center
  • Poteau, OK
  • NPI 1609700079
  NPD tax ID

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

{
    "created_epoch": "1779408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1952231789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1278",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749531278",
            "telephone_number": "918-649-3777",
            "fax_number": "918-647-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 DEWEY AVE",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534409",
            "telephone_number": "918-721-0140",
            "fax_number": "918-647-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-CARE FAMILY HEALTH OF OKLAHOMA , LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRO-CARE FAMILY HEALTH OF OKLAHOMA , LLC",
        "enumeration_date": "2026-05-22",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "TUSTIN",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "918-649-3777"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro-Care Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jayden A Potter
• Tori Prince
• Pro Care Family Health of Leflore County
• Pro-Care Family Health of Oklahoma , LLC
• Pro-Care Family Health of Oklahoma , LLC
• Tonia Pruitt
• Lexi Pryor
• Tiffany Puckett, APRN-CNP
• Tina Key Raines, LLC
• Randall J Matos DPM PC

• Rural Health Clinic/Center in Poteau, OK
• Providers in Poteau, OK by specialty
• Rural Health Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.