NPIMap

Organization Active NPI

Eyesguys LLC

Doing business as Eye Care Center

  • Optometrist
  • Edmond, OK
National Provider Identifier
1104195825
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2653 Issued in OK
Legal business name
EYESGUYS LLC
Doing business as
Eye Care Center
Practice address
16135 N May Ave Ste a
Edmond, OK 73013-8977
Phone
(405) 751-5638
Fax
(405) 702-9423
NPI assigned
Dec 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tyler W Glaze, ODNPI 1285947432
Title
Manager
Phone
(405) 626-5503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2653 OK Primary

Addresses

Primary practice location

16135 N May Ave Ste a
Edmond, OK 73013-8977

Mailing address

16135 N May Ave Ste a
Edmond, OK 73013-8977
Phone (405) 751-5638

Other names 1

  • Eye Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120127000711 OK Part B Supplier - Clinic/Group Practice 1456518745 Receives reassigned benefits from 5 practitioners
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1104195825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16135 N MAY AVE STE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138977",
            "telephone_number": "405-751-5638",
            "fax_number": "405-704-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16135 N MAY AVE STE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138977",
            "telephone_number": "405-751-5638",
            "fax_number": "405-702-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYESGUYS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "GLAZE",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-626-5503",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.