Organization
ENVISION MEDICAL & SURGICAL EYE CARE PC
Active
Organization
ENVISION MEDICAL & SURGICAL EYE CARE PC
Active
Parent organization
ENVISION MEDICAL AND SURGICAL EYE CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ENVISION MEDICAL AND SURGICAL EYE CARE
Authorized official
MIRANDA K RENFROW D.O. (PRESIDENT)
(918) 605-7456
Entity
Organization
Contact information
Practice address
4926 W KENOSHA ST, BROKEN ARROW, OK 74012-8517
(918) 605-7456
(918) 893-1724
Mailing address
4926 W KENOSHA ST, BROKEN ARROW, OK 74012-8517
(918) 605-7456
(918) 893-1724
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4949
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OKA102502
MEDICARE PTAN
OK
Enumeration date
02/05/2013
Last updated
05/24/2016
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