Provider Demographics
NPI:1578321949
Name:TULSA PROCEDURE SUITES LLC
Entity type:Organization
Organization Name:TULSA PROCEDURE SUITES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-935-2040
Mailing Address - Street 1:8131 S MEMORIAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4348
Mailing Address - Country:US
Mailing Address - Phone:918-200-9944
Mailing Address - Fax:
Practice Address - Street 1:2408 E 81ST ST STE 600
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4316
Practice Address - Country:US
Practice Address - Phone:918-935-2040
Practice Address - Fax:918-935-2049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty