MEDICARE: MCRAY EYECARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	809	OK

General Provider Information

NPI Number	:	1215932629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCRAY EYECARE PLLC

Provider Business Mailing Address
First Line	:	PO BOX 1372
Second Line	:
City	:	CHICKASHA
State	:	OK
Zip	:	73023-1372
Country	:	US
Telephone Number	:	405-203-5520
Fax Number	:	405-632-6331

Provider Business Practice Location Address
First Line	:	2700 SW 29TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73119-1806
Country	:	US
Telephone Number	:	405-632-9749
Fax Number	:	405-632-6331

Authorized Official
Title or Position	:	OPTOMETRIST / MANAGER
Name	:	DR. JOHN R MCRAY
Credential	:	OD
Telephone Number	:	405-632-9749

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	08/22/2020

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