Provider Demographics
NPI:1194920652
Name:PRECISION OPTICAL OF OKLA INC
Entity type:Organization
Organization Name:PRECISION OPTICAL OF OKLA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:TED
Authorized Official - Last Name:DAKIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-251-6442
Mailing Address - Street 1:520 SOUTH ELM PLACE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012
Mailing Address - Country:US
Mailing Address - Phone:918-251-6442
Mailing Address - Fax:918-251-6442
Practice Address - Street 1:520 SOUTH ELM PLACE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012
Practice Address - Country:US
Practice Address - Phone:918-251-6442
Practice Address - Fax:918-251-6442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK131654156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty