Organization
THUNDER CITY EYE CARE LLC
Active
Other names
Thunder City Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
CARISSA BEAUDREAU OD (OWNER)
(405) 832-5117
Entity
Organization
Contact information
Practice address
13200 N WESTERN AVE STE A, OKLAHOMA CITY, OK 73114-1434
(405) 024-5306
Mailing address
13200 N WESTERN AVE STE A, OKLAHOMA CITY, OK 73114-1434
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J8987
MES VISION
—
Enumeration date
11/10/2020
Last updated
01/13/2021
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