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General NPI Number Information
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NPI Number | 1629284591
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Entity Type | Organization
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Legal Business Name | XEYES,INC.
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 29500 W. SEVEN MILE
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City | LIVONIA
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State | MI
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Zip | 48152
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Country | US
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Telephone | 248-477-2662
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Fax |
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Provider Business Mailing Address
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Address Line | 5893 TOWER RD.
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City | PLYMOUTH
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State | MI
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Zip | 48170
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Country | US
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Telephone | 434-459-1297
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MARK WESLEY OSORIO
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Credential | O.D.
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Telephone | 734-459-1297
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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 | 4901004087
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License Number State | MI
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