Organization
ENVISION SPECIALTY EYECARE AND DRY EYE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ROBERT BESECKER OD, MS (OWNER/MANAGER)
(208) 490-8823
Entity
Organization
Contact information
Practice address
1130 E FAIRVIEW AVE, MERIDIAN, ID 83642-1813
(208) 859-5125
Mailing address
1130 E FAIRVIEW AVE, MERIDIAN, ID 83642-1813
(208) 490-8823
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010000322
BLUE SHIELD
ID
Enumeration date
03/03/2021
Last updated
07/07/2021
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