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General NPI Number Information
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NPI Number | 1932389145
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Entity Type | Organization
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Legal Business Name | SHELLY RICE OD PC INC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 512 E CHEROKEE ST
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City | WAGONER
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State | OK
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Zip | 74467-4710
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Country | US
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Telephone | 918-485-4775
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Fax | 918-485-7611
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Provider Business Mailing Address
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Address Line | 512 E CHEROKEE ST
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City | WAGONER
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State | OK
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Zip | 74467-4710
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Country | US
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Telephone | 918-485-4775
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Fax | 918-485-7611
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Authorized Official
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Title or Position | OWNER
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Name | SHELLY DEANN RICE
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Credential | OD
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Telephone | 918-485-4775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 2284
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 2284
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 2284
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | 2284
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 2284
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number | 2284
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License Number State | OK
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Taxonomy #7
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 2284
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License Number State | OK
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Taxonomy #8
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2284
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License Number State | OK
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