Healthcare Provider Details

I. General information

NPI: 1982143095
Provider Name (Legal Business Name): ONE VISION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 W KENOSHA ST
BROKEN ARROW OK
74012-8948
US

IV. Provider business mailing address

3505 W KENOSHA ST
BROKEN ARROW OK
74012-8948
US

V. Phone/Fax

Practice location:
  • Phone: 918-286-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JAMES THIRION
Title or Position: OWNER
Credential:
Phone: 918-286-2020