Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Madras Vision Source PC

Organization Optometrist · NPI 1164791414

Madras Vision Source PC is an Optometrist in Madras, Oregon. Licensed in Oregon. Registered with an NPI since 2011.

Licensed in
OR
In the registry since
2011
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

211 SE 5th St
Madras, OR 97741
Phone: (541) 475-2020
Fax: (541) 475-6118
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 3215ATI (OR)
Eyewear Supplier Taxonomy 332H00000X

Record details

NPI number1164791414
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMadras Vision Source PC
Authorized official Jessica Tegan — Owner · (541) 475-2020
Other names Madras Vision Source Llc
NPI enumeratedDecember 15, 2011
Last updated in NPPESMay 17, 2022
Certification dateMay 17, 2022
Mailing address211 Se 5th St, Madras, OR 97741

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