Provider Demographics
NPI:1194053660
Name:IDEAL EYE CARE, P.C.
Entity type:Organization
Organization Name:IDEAL EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-364-2020
Mailing Address - Street 1:444 24TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5110
Mailing Address - Country:US
Mailing Address - Phone:405-364-2020
Mailing Address - Fax:405-364-2021
Practice Address - Street 1:444 24TH AVE SW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5110
Practice Address - Country:US
Practice Address - Phone:405-364-2020
Practice Address - Fax:405-364-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-22
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2605152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200268510AMedicaid
6376460001Medicare NSC
OKB5853Medicare PIN
OKDR4471Medicare PIN