Individual
DR. EVELYN OKAH AYIDU-OMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
4801 S COOPER ST, ARLINGTON, TX 76017-5928
(817) 419-9999
(817) 375-1712
Mailing address
1005 MAZOURKA DR, ARLINGTON, TX 76001-6119
(817) 419-9999
(817) 375-1712
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6385T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008FF
BLUE CROSS BLUE SHIELD
TX
01
—
341979359
SAFEGUARD
TX
01
—
49187
DAVIS VISION
TX
01
—
743019386
NVA/ALWAYS VISION
TX
01
—
921667
TRUVISION(BLOCK)
TX
Enumeration date
08/18/2006
Last updated
07/08/2007
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