Provider Demographics
NPI:1861705659
Name:MCDANIELS, CHRISTOPHER MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:MCDANIELS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:MICHAEL
Other - Last Name:MCDANIELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:3746 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-3265
Mailing Address - Country:US
Mailing Address - Phone:918-992-5337
Mailing Address - Fax:918-992-5338
Practice Address - Street 1:3746 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-3265
Practice Address - Country:US
Practice Address - Phone:918-992-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2661152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist