Provider Demographics
NPI:1275661225
Name:SOUTHWEST EYE INSTITUTE, INC.
Entity Type:Organization
Organization Name:SOUTHWEST EYE INSTITUTE, INC.
Other - Org Name:CLEARSIGHT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:WAINE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-722-2020
Mailing Address - Street 1:7101 NW EXPRESSWAY
Mailing Address - Street 2:SUITE 335
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-1561
Mailing Address - Country:US
Mailing Address - Phone:405-722-2020
Mailing Address - Fax:405-516-6126
Practice Address - Street 1:7101 NW EXPRESSWAY
Practice Address - Street 2:SUITE 335
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-1561
Practice Address - Country:US
Practice Address - Phone:405-722-2020
Practice Address - Fax:405-516-6126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty