Provider Demographics
NPI:1346397445
Name:SIGHT TO SEE VISION ASSOCIATES P C INC
Entity type:Organization
Organization Name:SIGHT TO SEE VISION ASSOCIATES P C INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAINA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-341-7055
Mailing Address - Street 1:701 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3936
Mailing Address - Country:US
Mailing Address - Phone:405-341-7055
Mailing Address - Fax:405-348-7702
Practice Address - Street 1:701 S BROADWAY
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3936
Practice Address - Country:US
Practice Address - Phone:405-341-7055
Practice Address - Fax:405-348-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK0841152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOK0841OtherSTATE LICENSE
OK200037850AMedicaid
OK200037850AMedicaid
OK441465781PMedicare ID - Type Unspecified
OK4133270001Medicare NSC