MEDICARE: EYECARE BOULEVARD, P.L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2773	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437697364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYECARE BOULEVARD, P.L.L.C.

Provider Business Mailing Address
First Line	:	9777 N COUNCIL RD
Second Line	:	APT 1124
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-5500
Country	:	US
Telephone Number	:	405-473-2899
Fax Number	:

Provider Business Practice Location Address
First Line	:	7314 N WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-7120
Country	:	US
Telephone Number	:	405-437-0763
Fax Number	:	405-437-0764

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. MY DINH
Credential	:	O.D.
Telephone Number	:	405-473-2899

Provider Enumeration Date	:	02/11/2017
Last Update Date	:	07/09/2018

Similar Medicare Providers

1164057543 — DIANA TAMBOLI MD LLC
Practice Location Address:

7316 N WESTERN AVE
OKLAHOMA CITY, OK
73116-7120

Practice Phone: 405-408-4064
Practice Fax: 405-936-0561

1306635537 — REVITALIZE NUTRITION CORP
Practice Location Address:

7308 N WESTERN AVE
OKLAHOMA CITY, OK
73116-7120

Practice Phone: 405-625-6488
Practice Fax:

1558474015 — MR. WILLIAM MARTIN KOHS DDS
Practice Location Address:

7120 S PENNSYLVANIA AVE
OKLAHOMA CITY, OK
73159-3315

Practice Phone: 405-681-6601
Practice Fax: 405-685-8505

1265831002 — KELLEY BYERS
Practice Location Address:

804 NW 39TH ST
OKLAHOMA CITY, OK
73118-7120

Practice Phone: 405-570-5037
Practice Fax:

1033679089 — BRK, PLLC
Practice Location Address:

7120 S PENNSYLVANIA AVE
OKLAHOMA CITY, OK
73159-3315

Practice Phone: 405-681-6601
Practice Fax:

1336715010 — ANH HUYEN BUI DDS
Practice Location Address:

7120 S PENNSYLVANIA AVE
OKLAHOMA CITY, OK
73159-3315

Practice Phone: 405-681-6601
Practice Fax:

Directions to “EYECARE BOULEVARD, P.L.L.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.