Provider Demographics
NPI:1619497898
Name:L & P OCULAR PROSTHETICS
Entity Type:Organization
Organization Name:L & P OCULAR PROSTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCULARIST
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-831-4373
Mailing Address - Street 1:PO BOX 263
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73101-0263
Mailing Address - Country:US
Mailing Address - Phone:405-831-4373
Mailing Address - Fax:405-724-5016
Practice Address - Street 1:4409 N MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73112-2401
Practice Address - Country:US
Practice Address - Phone:405-757-9206
Practice Address - Fax:405-724-5016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Single Specialty