Provider Demographics
NPI:1811191232
Name:DR. CURT MASSENGALE & ASSOCIATES
Entity type:Organization
Organization Name:DR. CURT MASSENGALE & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CURT
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:MASSENGALE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-631-2020
Mailing Address - Street 1:7000 CROSSROADS MALL
Mailing Address - Street 2:SUITE 2086
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73149-4226
Mailing Address - Country:US
Mailing Address - Phone:405-631-2020
Mailing Address - Fax:405-631-2114
Practice Address - Street 1:7000 CROSSROADS MALL
Practice Address - Street 2:SUITE 2086
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73149-4226
Practice Address - Country:US
Practice Address - Phone:405-631-2020
Practice Address - Fax:405-631-2114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. CURT MASSENGALE & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-11
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK1089152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT40553Medicare UPIN