Provider Demographics
NPI:1518987353
Name:MILLER VISION CARE PC
Entity type:Organization
Organization Name:MILLER VISION CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD/PRESIDENT/AO
Authorized Official - Phone:405-364-2733
Mailing Address - Street 1:316 W MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1311
Mailing Address - Country:US
Mailing Address - Phone:405-364-2733
Mailing Address - Fax:405-364-2737
Practice Address - Street 1:316 W MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1311
Practice Address - Country:US
Practice Address - Phone:405-364-2733
Practice Address - Fax:405-364-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2278152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100749560AMedicaid