Organization
PAUL C. TISDAL, O.D., P.C.
Active
Other names
Weatherford Eyecare Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL CARROLL TISDAL O.D. (PRESIDENT)
(580) 772-2819
Entity
Organization
Contact information
Practice address
1545 N. WASHINGTON AVE, WEATHERFORD, OK 73096
(158) 072-2819
(158) 077-2280
Mailing address
P.O. BOX 308, WEATHERFORD, OK 73096
(580) 772-2819
(580) 772-2805
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1016
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760430938
NPI TYPE 1
OK
Enumeration date
05/04/2007
Last updated
08/22/2020
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