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General NPI Number Information
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NPI Number | 1124332846
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Entity Type | Organization
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Legal Business Name | OKLAHOMA MOBILE EYE CARE ASSOCIATES
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 2805 NW 158TH ST
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City | EDMOND
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State | OK
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Zip | 73013-8821
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Country | US
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Telephone | 405-397-7054
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Fax |
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Provider Business Mailing Address
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Address Line | 2805 NW 158TH ST
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City | EDMOND
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State | OK
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Zip | 73013-8821
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Country | US
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Telephone | 405-397-7054
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/CEO
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Name | DR. CHRISTOPHER P LYONS
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Credential | O.D.
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Telephone | 405-397-7054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2487
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License Number State | OK
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