Individual
COOPER FREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1009 TEXAS ST, WOODWARD, OK 73801-3127
(580) 254-8020
(580) 254-8377
Mailing address
1009 TEXAS ST, WOODWARD, OK 73801-3127
(580) 254-8020
(580) 254-8377
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3220
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3220
OK STATE BOARD OF OPTOMETRY
OK
Enumeration date
07/25/2023
Last updated
07/25/2023
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