Provider Demographics
NPI:1215993001
Name:FRANTZ, MYRA JOY (OD, PC)
Entity type:Individual
Prefix:DR
First Name:MYRA
Middle Name:JOY
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:OD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2084
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-8084
Mailing Address - Country:US
Mailing Address - Phone:580-772-2020
Mailing Address - Fax:
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-5346
Practice Address - Country:US
Practice Address - Phone:580-772-2020
Practice Address - Fax:580-772-0191
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2188152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
$$$$$$$$$Medicare PIN
OKU62449Medicare UPIN