Healthcare Provider Details

I. General information

NPI: 1235263799
Provider Name (Legal Business Name): DRS. HINKLE & CASH OPT,, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12720 E 86TH ST N
OWASSO OK
74055-2548
US

IV. Provider business mailing address

P. O. BOX 300
OWASSO OK
74055
US

V. Phone/Fax

Practice location:
  • Phone: 918-272-5311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: SHELLEY MOODY
Title or Position: OFFICE MGR.
Credential: LPN
Phone: 918-272-5311