Provider Demographics
NPI:1548483100
Name:LEWIS & LEWIS EYE CARE CLINIC, P. C.
Entity type:Organization
Organization Name:LEWIS & LEWIS EYE CARE CLINIC, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:405-390-9106
Mailing Address - Street 1:14975 BYPASS ST
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-8504
Mailing Address - Country:US
Mailing Address - Phone:405-390-9106
Mailing Address - Fax:405-390-1105
Practice Address - Street 1:14975 BYPASS ST
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-8504
Practice Address - Country:US
Practice Address - Phone:405-390-9106
Practice Address - Fax:405-390-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2072 AND 768152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1053311183OtherTERRY LEWIS NPI
OK456607937001OtherLARRY LEWIS BLUE CROSS
OK100766570AMedicaid
OK443703087OtherTERRY LEWIS
OK1317550002OtherPALMETTO GBA DMERC
OK1952301095OtherLARRY LEWIS NPI
OK443703087001OtherTERRY LEWIS BLUE CROSS
OK456607937OtherLARRY LEWIS
OK700522004OtherMEDICARE PTAN
OK100763240AMedicaid
OK=========001OtherBLUE CROSS BLUE SHIELD
OK100766570AMedicaid
OK443703087001OtherTERRY LEWIS BLUE CROSS
OKT40543Medicare UPIN