Organization
ORLANDO A DIAZ JR
Active
Other names
Orlando A Diaz OD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ORLANDO A DIAZ JR. OD (OWNER)
(405) 473-3937
Entity
Organization
Contact information
Practice address
660 SW 19TH ST STE G, MOORE, OK 73160-5406
(405) 794-0176
(405) 794-0176
Mailing address
114 RENE PL, SHAWNEE, OK 74804-8980
(405) 473-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1153
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100761630A
—
OK
Enumeration date
03/21/2018
Last updated
03/21/2018
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