Provider Demographics
NPI:1861443772
Name:THOMAS EYE CARE PC
Entity Type:Organization
Organization Name:THOMAS EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:LANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:918-376-2700
Mailing Address - Street 1:12406 E 86TH ST N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-2500
Mailing Address - Country:US
Mailing Address - Phone:918-376-2700
Mailing Address - Fax:918-376-2722
Practice Address - Street 1:12406 E 86TH ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-2500
Practice Address - Country:US
Practice Address - Phone:918-376-2700
Practice Address - Fax:918-376-2722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2214152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU68294Medicare UPIN
OK300522080Medicare PIN