Provider Demographics
NPI:1659723187
Name:HEARTLAND FAMILY EYECARE P.L.L.C.
Entity Type:Organization
Organization Name:HEARTLAND FAMILY EYECARE P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-237-9379
Mailing Address - Street 1:705 S OAKWOOD RD
Mailing Address - Street 2:SUITE C1
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-6277
Mailing Address - Country:US
Mailing Address - Phone:580-237-9379
Mailing Address - Fax:580-237-9380
Practice Address - Street 1:705 S OAKWOOD RD
Practice Address - Street 2:SUITE C1
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-6277
Practice Address - Country:US
Practice Address - Phone:580-237-9379
Practice Address - Fax:580-237-9380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2854152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty