Provider Demographics
NPI:1952036204
Name:MOORE, CLAIRE LAUREN (OD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:LAUREN
Last Name:MOORE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11016 N GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-5831
Mailing Address - Country:US
Mailing Address - Phone:405-593-9920
Mailing Address - Fax:
Practice Address - Street 1:3101 N SOONER RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8333
Practice Address - Country:US
Practice Address - Phone:405-341-9480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3186152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist