Provider Demographics
NPI:1639599889
Name:SOLUTIONS PRACTICE MANAGEMENT
Entity Type:Organization
Organization Name:SOLUTIONS PRACTICE MANAGEMENT
Other - Org Name:MILLER EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR/CBO
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUMPAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-251-6656
Mailing Address - Street 1:2210 DUNCAN REGIONAL LOOP
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1564
Mailing Address - Country:US
Mailing Address - Phone:580-251-8212
Mailing Address - Fax:580-251-6668
Practice Address - Street 1:1311 JACKIE RD
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1566
Practice Address - Country:US
Practice Address - Phone:580-255-2501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11524332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200135670KMedicaid