Provider Demographics
NPI:1811743602
Name:GLAUCOMA SURGEONS OF OKLAHOMA PLLC
Entity type:Organization
Organization Name:GLAUCOMA SURGEONS OF OKLAHOMA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:KHAIMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-255-3839
Mailing Address - Street 1:1800 RENAISSANCE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3023
Mailing Address - Country:US
Mailing Address - Phone:405-920-5222
Mailing Address - Fax:405-920-5209
Practice Address - Street 1:1800 RENAISSANCE BLVD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3023
Practice Address - Country:US
Practice Address - Phone:405-920-5222
Practice Address - Fax:405-920-5209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Single Specialty