Healthcare Provider Details

I. General information

NPI: 1548483100
Provider Name (Legal Business Name): LEWIS & LEWIS EYE CARE CLINIC, P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14975 BYPASS ST
CHOCTAW OK
73020-8504
US

IV. Provider business mailing address

14975 BYPASS ST
CHOCTAW OK
73020-8504
US

V. Phone/Fax

Practice location:
  • Phone: 405-390-9106
  • Fax: 405-390-1105
Mailing address:
  • Phone: 405-390-9106
  • Fax: 405-390-1105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2072 AND 768
License Number StateOK

VIII. Authorized Official

Name: DR. TERRY NEAL LEWIS
Title or Position: OWNER
Credential: O. D.
Phone: 405-390-9106