Organization
SOUTHWEST EYE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID B MALLORY MD (CEO/MANAGER)
(405) 631-1527
Entity
Organization
Contact information
Practice address
1240 SW 44TH ST, OKLAHOMA CITY, OK 73109-3604
(405) 631-1527
(405) 631-9930
Mailing address
1240 SW 44TH ST, OKLAHOMA CITY, OK 73109-3604
(405) 631-1527
(405) 631-9930
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
208D00000X
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100059640A
—
OK
Enumeration date
10/18/2006
Last updated
08/06/2024
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