Organization
PARKSIDE EYECARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER JULIE MOORE OD (OPTOMETRIST)
(405) 824-3181
Entity
Organization
Contact information
Practice address
318 S LITTLER AVE, EDMOND, OK 73034-3823
(405) 341-3567
(405) 359-2000
Mailing address
318 S LITTLER AVE, EDMOND, OK 73034-3823
(405) 341-3567
(405) 359-2000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200115110A
—
OK
Enumeration date
11/30/2019
Last updated
09/12/2020
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