Provider Demographics
NPI:1851560668
Name:NB SOURCE
Entity Type:Organization
Organization Name:NB SOURCE
Other - Org Name:VISION BEST EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:NGUYEN
Authorized Official - Last Name:BEST
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:865-771-3018
Mailing Address - Street 1:PO BOX 24626
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37933-2626
Mailing Address - Country:US
Mailing Address - Phone:865-771-3018
Mailing Address - Fax:
Practice Address - Street 1:11663 PARKSIDE DR.
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934
Practice Address - Country:US
Practice Address - Phone:865-771-3018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2610152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty