Provider Demographics
NPI:1174693279
Name:BROWNLEE OPTOMETRY PLLC
Entity type:Organization
Organization Name:BROWNLEE OPTOMETRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BROWNLEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-373-4510
Mailing Address - Street 1:51 GOODER SIMPSON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OK
Mailing Address - Zip Code:73078-9237
Mailing Address - Country:US
Mailing Address - Phone:405-373-4310
Mailing Address - Fax:
Practice Address - Street 1:51 GOODER SIMPSON BLVD.
Practice Address - Street 2:STE. C
Practice Address - City:PIEDMONT
Practice Address - State:OK
Practice Address - Zip Code:73078
Practice Address - Country:US
Practice Address - Phone:405-373-4510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK2412152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty