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General NPI Number Information
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NPI Number | 1013687045
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Entity Type | Organization
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Legal Business Name | CENTRAL FAMILY EYECARE, LLC
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 2000 W MEMORIAL RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-6506
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Country | US
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Telephone | 405-876-6393
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 W MEMORIAL RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-6506
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Country | US
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Telephone | 405-876-6393
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF OPTOMETRY OWNER
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Name | DR. ELIZABETH HART-CARLOCK
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Credential | OD
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Telephone | 405-876-6393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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