Organization
MUSTANG OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNITH D BUTLER (OWNER)
(405) 376-0222
Entity
Organization
Contact information
Practice address
123 N MUSTANG RD, MUSTANG, OK 73064-3912
(405) 376-0222
(405) 376-0233
Mailing address
123 N MUSTANG RD, MUSTANG, OK 73064-3912
(405) 376-0222
(405) 376-0233
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100769000A
—
OK
Enumeration date
01/17/2008
Last updated
06/07/2022
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