Provider Demographics
NPI:1275906760
Name:EYECARE OF CATOOSA HILLS
Entity Type:Organization
Organization Name:EYECARE OF CATOOSA HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:918-266-3937
Mailing Address - Street 1:2036 S MILLER LN
Mailing Address - Street 2:SUITE E
Mailing Address - City:CATOOSA
Mailing Address - State:OK
Mailing Address - Zip Code:74015-1520
Mailing Address - Country:US
Mailing Address - Phone:918-266-3937
Mailing Address - Fax:918-266-4019
Practice Address - Street 1:2036 S MILLER LN
Practice Address - Street 2:SUITE E
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015-1520
Practice Address - Country:US
Practice Address - Phone:918-266-3937
Practice Address - Fax:918-266-4019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2564152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty