Provider Demographics
NPI:1982149969
Name:NORMAN VISION CLINIC, PLLC
Entity Type:Organization
Organization Name:NORMAN VISION CLINIC, PLLC
Other - Org Name:MOORE VISION SOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLAX
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:4053-212-1255
Mailing Address - Street 1:705 CITY AVE
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-3819
Mailing Address - Country:US
Mailing Address - Phone:405-794-7544
Mailing Address - Fax:405-794-7599
Practice Address - Street 1:705 CITY AVE
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3819
Practice Address - Country:US
Practice Address - Phone:405-794-7544
Practice Address - Fax:405-794-7599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2098152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty