Provider Demographics
NPI:1952674913
Name:TRINA PIPER-HUGHBANKS O D INC
Entity Type:Organization
Organization Name:TRINA PIPER-HUGHBANKS O D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPER-HUGHBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-327-3335
Mailing Address - Street 1:410 4TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-2363
Mailing Address - Country:US
Mailing Address - Phone:580-327-3335
Mailing Address - Fax:
Practice Address - Street 1:410 4TH ST STE D
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:OK
Practice Address - Zip Code:73717-2363
Practice Address - Country:US
Practice Address - Phone:580-327-3335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2165152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100761710AMedicaid
OKOKA103780Medicare PIN