Provider Demographics
NPI:1487603395
Name:OKLAHOMA EYE CARE ASSOCIATES,P.L.L.C.
Entity type:Organization
Organization Name:OKLAHOMA EYE CARE ASSOCIATES,P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-737-1000
Mailing Address - Street 1:2150 S DOUGLAS BLVD
Mailing Address - Street 2:SUTE C
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-6200
Mailing Address - Country:US
Mailing Address - Phone:405-737-1000
Mailing Address - Fax:405-741-4388
Practice Address - Street 1:2150 S DOUGLAS BLVD
Practice Address - Street 2:SUTE C
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6200
Practice Address - Country:US
Practice Address - Phone:405-737-1000
Practice Address - Fax:405-741-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK-13218261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOK-13218OtherSTATE LICENSE
OKOK-13218OtherSTATE LICENSE
OKAW1146047OtherDEA#