| Organization Name: | TRIAD EYE MEDICAL CLINIC AND CATARACT INSTITUTE PLLC |
| NPI Number: | 1083030597 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RYAN P CONLEY (OWNER) |
| Mailing Address: | 63223 E 290 Rd Grove |
| State: | OK US |
| Postal Code: | 743447552 |
| Phone Number: | 9182522020 |
| Fax Number: | 9183071983 |
| NPI Enumeration Date: | 03/07/2014 |
| NPI Last Update Date: | 03/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |