Southern Oklahoma Eye Center LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SOUTHERN OKLAHOMA EYE CENTER LLC

Practice address

1010 W 3Rd St
Sulphur, OK 73086-4801

Phone

(580) 622-2020

Fax

(580) 622-3213

NPI assigned

Dec 13, 2006

Last updated

Dec 12, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kristy Marie Cain, CPO

Title

Insurance Clerk

Phone

(580) 622-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southern Oklahoma Eye Center, LLC

  • Optometrist
  • Wynnewood, OK
  • NPI 1699818864

  O20101008000576

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Evan Lee Bragg, O.D.

  • Optometrist
  • Sulphur, OK
  • NPI 1811058589
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1184785867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W 3RD ST",
            "address_2": "PO BOX 499",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864801",
            "telephone_number": "580-622-2020",
            "fax_number": "580-622-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W 3RD ST",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864801",
            "telephone_number": "580-622-2020",
            "fax_number": "580-622-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OKLAHOMA EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "CAIN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "INSURANCE CLERK",
        "authorized_official_telephone_number": "580-622-2020",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sole'Renity Spa, Inc.
• Sooner Pharmacy
• Sooner Pharmacy
• Sooner Pharmacy of Oklahoma LLC
• Southeastern Oklahoma Family Services, Inc.
• Southern Oklahoma Treatment Services (OK Behavioral Health)
• State of Oklahoma (Sulphur Veterans Center)
• Sulphur Clinic Inc.
• Sulphur Dentistry & Braces
• Sulphur Manor Inc (Callaway Nursing Home)

• Optometrist in Sulphur, OK
• Providers in Sulphur, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.