Provider Demographics
NPI:1073286266
Name:MOORE, PRIYA FILINTO
Entity Type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:FILINTO
Last Name:MOORE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:PRIYA
Other - Middle Name:MADISON
Other - Last Name:FILINTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2817 DRAKESTONE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-4560
Mailing Address - Country:US
Mailing Address - Phone:405-406-5062
Mailing Address - Fax:
Practice Address - Street 1:1021 24TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6365
Practice Address - Country:US
Practice Address - Phone:405-329-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3136152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist