Provider Demographics
NPI:1265630032
Name:OPTICS INC ECONOMY SQUARE OPTICAL
Entity Type:Organization
Organization Name:OPTICS INC ECONOMY SQUARE OPTICAL
Other - Org Name:DONNAS OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OPITICIAN
Authorized Official - Phone:405-681-2411
Mailing Address - Street 1:1605 SW 59TH
Mailing Address - Street 2:DONNAS OPTICAL
Mailing Address - City:OK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73119
Mailing Address - Country:US
Mailing Address - Phone:405-681-2411
Mailing Address - Fax:
Practice Address - Street 1:1605 SW 59
Practice Address - Street 2:DONNAS OPTICAL
Practice Address - City:OK CITY
Practice Address - State:OK
Practice Address - Zip Code:73119
Practice Address - Country:US
Practice Address - Phone:405-681-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0758240001Medicare ID - Type Unspecified