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General NPI Number Information
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NPI Number | 1306467618
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Entity Type | Organization
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Legal Business Name | TABOR EYE CLINIC, LLC
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 119 W MAIN ST
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City | DAVIS
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State | OK
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Zip | 73030-1747
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Country | US
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Telephone | 580-369-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 119 W MAIN ST
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City | DAVIS
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State | OK
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Zip | 73030-1747
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Country | US
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Telephone | 580-369-3937
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KIMBERLY TABOR
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Credential |
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Telephone | 580-369-3937
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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 |
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License Number State |
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