Provider Demographics
NPI:1215932629
Name:MCRAY EYECARE PLLC
Entity type:Organization
Organization Name:MCRAY EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST / MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-632-9749
Mailing Address - Street 1:PO BOX 1372
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73023-1372
Mailing Address - Country:US
Mailing Address - Phone:405-203-5520
Mailing Address - Fax:405-632-6331
Practice Address - Street 1:2700 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73119-1806
Practice Address - Country:US
Practice Address - Phone:405-632-9749
Practice Address - Fax:405-632-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK809152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T40568Medicare UPIN