| NPI | 1417035684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WALLACE CROFT Owner 580-924-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 19261) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 32094) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2016-06-24 |