Provider Demographics
NPI:1194377168
Name:PARTIN EYECARE PC
Entity Type:Organization
Organization Name:PARTIN EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:PARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-376-9779
Mailing Address - Street 1:1100 N MUSTANG RD
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-7201
Mailing Address - Country:US
Mailing Address - Phone:405-376-9779
Mailing Address - Fax:405-376-9668
Practice Address - Street 1:1100 N MUSTANG RD
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-7201
Practice Address - Country:US
Practice Address - Phone:405-376-9779
Practice Address - Fax:405-376-9668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty