Provider Demographics
NPI:1013057496
Name:MYRA JOY FRANTZ O.D., P.C.
Entity type:Organization
Organization Name:MYRA JOY FRANTZ O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:FRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD, PC
Authorized Official - Phone:580-772-2020
Mailing Address - Street 1:PO BOX 2084
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-8084
Mailing Address - Country:US
Mailing Address - Phone:580-772-2020
Mailing Address - Fax:580-772-0191
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-5351
Practice Address - Country:US
Practice Address - Phone:580-772-2020
Practice Address - Fax:580-772-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2188152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100762670BMedicaid
OK=========OtherTAX IDENTIFICATION #
OKOKB5051Medicare PIN
OK=========OtherTAX IDENTIFICATION #