Provider Demographics
NPI:1558358473
Name:CATES, TYLER OWEN (OD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:OWEN
Last Name:CATES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4603
Mailing Address - Country:US
Mailing Address - Phone:541-686-1237
Mailing Address - Fax:541-484-2026
Practice Address - Street 1:1471 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4603
Practice Address - Country:US
Practice Address - Phone:541-686-1237
Practice Address - Fax:541-484-2026
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3099AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU66353Medicare UPIN
ORR100193Medicare PIN