Provider Demographics
NPI:1649612664
Name:BATES, ALBERT C
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:C
Last Name:BATES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 S HARVARD AVE
Mailing Address - Street 2:#140
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2290
Mailing Address - Country:US
Mailing Address - Phone:918-770-6670
Mailing Address - Fax:
Practice Address - Street 1:3701 S HARVARD AVE
Practice Address - Street 2:#140
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2290
Practice Address - Country:US
Practice Address - Phone:918-770-6670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor