Healthcare Provider Details

I. General information

NPI: 1801417464
Provider Name (Legal Business Name): BIBIN J CHERIAN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4107 N COUNCIL RD BLDG H
BETHANY OK
73008-3131
US

IV. Provider business mailing address

200 W COVELL RD
EDMOND OK
73003-2346
US

V. Phone/Fax

Practice location:
  • Phone: 405-495-5170
  • Fax: 405-787-0123
Mailing address:
  • Phone: 405-341-2062
  • Fax: 405-341-6553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3061
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: