Optometry Clinic,Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

801 Issued in OK

Legal business name

OPTOMETRY CLINIC,INC.

Practice address

2120 W Elk Ave RM 1
Duncan, OK 73533-1576

Phone

(580) 255-0249

Fax

(580) 255-0258

NPI assigned

May 3, 2007

Last updated

Sep 24, 2008By 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

Dr. Ronny M Laquey, O.D.

Title

President

Phone

(580) 255-0249

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1750503397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 W ELK AVE RM 1",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331576",
            "telephone_number": "580-255-0249",
            "fax_number": "580-255-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 W ELK AVE RM 1",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331576",
            "telephone_number": "580-255-0249",
            "fax_number": "580-255-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRY CLINIC,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "LAQUEY",
        "authorized_official_first_name": "RONNY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-255-0249",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100768480B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.