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General NPI Number Information
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NPI Number | 1194274589
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Entity Type | Organization
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Legal Business Name | PREMIER FAMILY EYE CARE, PLLC
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 1305 N 16TH AVE
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City | DURANT
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State | OK
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Zip | 74701-2134
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Country | US
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Telephone | 580-920-0400
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Fax | 580-920-9117
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Provider Business Mailing Address
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Address Line | 1305 N 16TH AVE
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City | DURANT
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State | OK
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Zip | 74701-2134
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Country | US
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Telephone | 580-920-0400
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Fax | 580-920-9117
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | CASEY WRIGHT
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Credential | OD
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Telephone | 580-920-0400
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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 | 2834
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License Number State | OK
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