| Weatherford Eyecare Center | |
|
1545 N Washington St Weatherford OK 73096-2518 | |
| (580) 772-2819 | |
| (580) 772-2805 |
| Full Name | Weatherford Eyecare Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1545 N Washington St, Weatherford, Oklahoma |
| Authorized Official Name and Position | Paul C Tisdal (OWNER) |
| Authorized Official Contact | 5807722819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Weatherford Eyecare Center 1545 N Washington St P.o. Box 308 Weatherford OK 73096-2518 Ph: (580) 772-2819 | Weatherford Eyecare Center 1545 N Washington St Weatherford OK 73096-2518 Ph: (580) 772-2819 |
| NPI Number | 1154500890 |
|---|---|
| Provider Enumeration Date | 10/30/2007 |
| Last Update Date | 05/25/2022 |
| Medicare PECOS PAC ID | 0749305928 |
|---|---|
| Medicare Enrollment ID | O20100910000831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154500890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 1046 (Oklahoma) | Primary |
| Provider Name | Jimmy D Smart |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114983897 PECOS PAC ID: 6305876921 Enrollment ID: I20060131000074 |
| Provider Name | Paul C Tisdal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760430938 PECOS PAC ID: 0648395822 Enrollment ID: I20100910000852 |
| Provider Name | Cooper Free |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134800071 PECOS PAC ID: 0446605687 Enrollment ID: I20231009002068 |
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