Provider Demographics
NPI:1740720333
Name:ALTUS FAMILY VISION, PLLC
Entity type:Organization
Organization Name:ALTUS FAMILY VISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-482-0051
Mailing Address - Street 1:112 VAL VERDE ST
Mailing Address - Street 2:STE C
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-1190
Mailing Address - Country:US
Mailing Address - Phone:580-482-0051
Mailing Address - Fax:580-482-7746
Practice Address - Street 1:112 VAL VERDE ST
Practice Address - Street 2:STE C
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-1190
Practice Address - Country:US
Practice Address - Phone:580-482-0051
Practice Address - Fax:580-482-7746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2505152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty