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General NPI Number Information
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NPI Number | 1609394931
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Entity Type | Organization
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Legal Business Name | ONEVISION, INC.
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3620 SOUTH DAKOTA AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20018
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Country | US
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Telephone | 617-620-1693
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Fax |
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Provider Business Mailing Address
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Address Line | 3620 SOUTH DAKOTA AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20018-3026
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Country | US
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Telephone | 617-620-1693
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST, PRESIDENT
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Name | DR. TYLER DE SOUZA
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Credential | O.D.
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Telephone | 929-335-1243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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