Provider Demographics
NPI:1538495577
Name:EYE CARE SERVICES
Entity Type:Organization
Organization Name:EYE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-562-2036
Mailing Address - Street 1:3431 S BOULEVARD ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5475
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 S VERMONT AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-1017
Practice Address - Country:US
Practice Address - Phone:405-947-1066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty