Provider Demographics
NPI:1982618534
Name:EYE HEALTH ASSOCIATES, P.L.L.C.
Entity Type:Organization
Organization Name:EYE HEALTH ASSOCIATES, P.L.L.C.
Other - Org Name:COMPLETE EYE CARE DOWNTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-248-0061
Mailing Address - Street 1:4250 NW CACHE RD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-3606
Mailing Address - Country:US
Mailing Address - Phone:580-248-0061
Mailing Address - Fax:580-248-0074
Practice Address - Street 1:4250 NW CACHE RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3606
Practice Address - Country:US
Practice Address - Phone:580-248-0061
Practice Address - Fax:580-248-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2288152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200127610AMedicaid
OK200127610AMedicaid
OK6390520001Medicare NSC
OKU75461Medicare UPIN