Provider Demographics
NPI:1871939033
Name:LOVING EYECARE, INC
Entity type:Organization
Organization Name:LOVING EYECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LOVING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:918-272-4900
Mailing Address - Street 1:9021 N 121ST EAST AVE
Mailing Address - Street 2:300B
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5373
Mailing Address - Country:US
Mailing Address - Phone:918-272-4900
Mailing Address - Fax:918-272-0224
Practice Address - Street 1:9021 N 121ST EAST AVE STE 100A
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-5432
Practice Address - Country:US
Practice Address - Phone:918-272-4900
Practice Address - Fax:918-272-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1158152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200104450AMedicaid