Healthcare Provider Details

I. General information

NPI: 1639308414
Provider Name (Legal Business Name): NVISION UNLIMITED EYEWEAR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 36TH AVE NW STE. 100
NORMAN OK
73072-2922
US

IV. Provider business mailing address

2300 36TH AVE NW STE. 100
NORMAN OK
73072-2922
US

V. Phone/Fax

Practice location:
  • Phone: 405-360-5505
  • Fax: 405-360-0771
Mailing address:
  • Phone: 405-360-5505
  • Fax: 405-360-0771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOHN JOHNSON
Title or Position: PARTNER/OPTICAN
Credential:
Phone: 405-360-5505