Provider Demographics
NPI:1801094644
Name:HEFNER POINTE YOUTH OPTICAL
Entity type:Organization
Organization Name:HEFNER POINTE YOUTH OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-751-2020
Mailing Address - Street 1:PO BOX 20488
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73156
Mailing Address - Country:US
Mailing Address - Phone:405-751-2020
Mailing Address - Fax:405-751-3838
Practice Address - Street 1:11013 HEFNER POINTE DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120
Practice Address - Country:US
Practice Address - Phone:405-751-2020
Practice Address - Fax:405-751-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier