Healthcare Provider Details

I. General information

NPI: 1316103401
Provider Name (Legal Business Name): AMBER ANN MAYES O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 NW 36TH ST
OKLAHOMA CITY OK
73112-7477
US

IV. Provider business mailing address

2800 NW 36TH ST
OKLAHOMA CITY OK
73112-7477
US

V. Phone/Fax

Practice location:
  • Phone: 405-943-2020
  • Fax:
Mailing address:
  • Phone: 405-943-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2570
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: