Provider Demographics
NPI:1356568117
Name:EYE SOLUTIONS INC
Entity type:Organization
Organization Name:EYE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-223-4500
Mailing Address - Street 1:1117 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-2354
Mailing Address - Country:US
Mailing Address - Phone:580-223-4500
Mailing Address - Fax:580-223-4540
Practice Address - Street 1:1117 WALNUT DR
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2354
Practice Address - Country:US
Practice Address - Phone:580-223-4500
Practice Address - Fax:580-223-4540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2402152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK447727214001OtherBLUE CROSS BLUE SHIELD
OK200022010AMedicaid
100522097Medicare PIN
OKU99016Medicare UPIN
OK200022010AMedicaid