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Organization

MID-DEL VISION SOURCE PLLC

Active
Parent organization
MID-DEL VISION SOURCE PLLC
Other names
The Oculist by Vision Source
Organization subpart
Yes

Provider details

NPI number
Legal business name
MID-DEL VISION SOURCE PLLC
Authorized official
CYNTHIA BACON (FINANCE DIRECTOR)
(405) 732-2277
Entity
Organization

Contact information

Practice address
1 NE 2ND ST STE 104, OKLAHOMA CITY, OK 73104-2224
(405) 732-2277
(405) 737-4776
Mailing address
2008 S POST RD, MIDWEST CITY, OK 73130-6610
(405) 732-2277
(405) 737-4776

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Enumeration date
07/07/2020
Last updated
07/07/2020
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