Henry, Larry Randall
Henry, Larry Randall is an individual health care provider with primary practice located at 14701 N Santa Fe Ave , Edmond OK 73013-3411. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Henry, Larry Randall can be contacted via phone (405) 752-2733.Contact Information
Primary practice address
14701 N Santa Fe Ave
Edmond OK 73013-3411
Phone: (405) 752-2733
Fax: (405) 752-2172
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2040 | Oklahoma |
Profile Details
| NPI number | 1932102894 |
|---|---|
| LBN Legal business name | Henry, Larry Randall |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | May 8th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932102894 | NPPES |
| Oklahoma | Other | 4628540 | AETNA |
| Oklahoma | Other | 1677321 | AETNA |
| Oklahoma | MEDICAID | 100765720A | AETNA |
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