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NPI Code Detail

MEDICARE: PRECISION VISION CARE, LLC.

MEDICARE: PRECISION VISION CARE, LLC.
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
1174400000XSpecialist18401OK
2152W00000XOptometrist2684OK

General Provider Information

NPI Number : 1770852865
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRECISION VISION CARE, LLC.
Provider Business Mailing Address
First Line : 6922 S WESTERN AVE
Second Line : SUITE 104
City : OKLAHOMA CITY
State : OK
Zip : 73139-1803
Country : US
Telephone Number : 405-636-1508
Fax Number :
Provider Business Practice Location Address
First Line : 6922 S WESTERN AVE
Second Line : SUITE 104
City : OKLAHOMA CITY
State : OK
Zip : 73139-1803
Country : US
Telephone Number : 405-636-1508
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DARRELL J PICKARD
Credential : M.D.
Telephone Number : 405-636-1508
Provider Enumeration Date : 12/20/2011
Last Update Date : 12/20/2011

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Directions to “PRECISION VISION CARE, LLC. ” Practice Location

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