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General NPI Number Information
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NPI Number | 1881745768
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Entity Type | Organization
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Legal Business Name | MAX D. VENARD, O.D., P.C.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 705 CITY AVE
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City | MOORE
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State | OK
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Zip | 73160-3819
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Country | US
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Telephone | 405-794-7544
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Fax | 405-794-7599
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Provider Business Mailing Address
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Address Line | 705 CITY AVE
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City | MOORE
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State | OK
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Zip | 73160-3819
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Country | US
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Telephone | 405-794-7544
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Fax | 405-794-7599
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAX D VENARD
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Credential | OD
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Telephone | 405-794-7544
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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 | 0932
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License Number State | OK
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