Provider Demographics
NPI:1740470079
Name:VISION CLINICS INC
Entity type:Organization
Organization Name:VISION CLINICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:918-369-2020
Mailing Address - Street 1:13404 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-3104
Mailing Address - Country:US
Mailing Address - Phone:918-369-2020
Mailing Address - Fax:918-369-8600
Practice Address - Street 1:13404 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-3104
Practice Address - Country:US
Practice Address - Phone:918-369-2020
Practice Address - Fax:918-369-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1065152W00000X
OK1050152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731189381001OtherBCBS
OK731189381002OtherBCBS
OKT40705Medicare UPIN
OK0931120001Medicare NSC
OK731189381001OtherBCBS