| Organization Name: | SOUTHWEST EYE CLINIC, PLLC |
| NPI Number: | 1225083512 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID B MALLORY (CEO/MANAGER) |
| Mailing Address: | 1240 Sw 44th St Oklahoma City |
| State: | OK US |
| Postal Code: | 731093604 |
| Phone Number: | 4056311527 |
| Fax Number: | 4056319930 |
| NPI Enumeration Date: | 05/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 18441 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |