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

Dr. Tylor Pravongviengkham, OD

Individual provider Optometrist · NPI 1235880493

Dr. Tylor Pravongviengkham, OD is an Optometry in Gilbert, Arizona. Graduated from Pennsylvania College of Optometry in 2021, 5 years ago. Practices with Richard E Wood OD and Associates LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
5
Trained at
Pennsylvania College of Optometry
Licensed in
AZ
In the registry since
2022
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

4915 E Baseline Rd Ste 115
Gilbert, AZ 85234-2966
Phone: (480) 279-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPT-002670 (AZ)

Record details

NPI number1235880493
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJanuary 10, 2022
Last updated in NPPESFebruary 27, 2025
Certification dateFebruary 27, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolPENNSYLVANIA COLLEGE OF OPTOMETRY
Graduated 2021 (5 years in practice)
Group practice Richard E Wood Od And Associates Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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