Healthcare Provider Details

I. General information

NPI: 1396030664
Provider Name (Legal Business Name): CATARACT INSTITUTE OF OKLAHOMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 S. BOULEVARD
EDMOND OK
73013
US

IV. Provider business mailing address

3840 S BOULEVARD STE 103
EDMOND OK
73013-5888
US

V. Phone/Fax

Practice location:
  • Phone: 405-455-3937
  • Fax: 405-726-8546
Mailing address:
  • Phone: 405-455-3937
  • Fax: 405-726-8546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateOK

VIII. Authorized Official

Name: DR. JOSEPH GIRA
Title or Position: CHIEF MEDICAL DIRECTOR
Credential: MD
Phone: 636-227-2600