Organization
TREE CITY EYECARE PLLC
Active
Other names
Optometric Center, Optometric Center, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIMEN DIXON OD (OWNER)
(208) 375-3871
Entity
Organization
Contact information
Practice address
700 N RAYMOND ST, BOISE, ID 83704-9261
(208) 375-3871
(208) 321-1765
Mailing address
700 N RAYMOND ST, BOISE, ID 83704-9261
(208) 375-3871
(208) 321-1765
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15989404214
—
ID
01
—
20015736
MEDICARE ID
ID
Enumeration date
01/09/2008
Last updated
08/04/2023
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