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NPI Code Detail

MEDICARE: VALLEY EYE ASSOCIATES PLLC

MEDICARE: VALLEY EYE ASSOCIATES PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1146AZ
2152WC0802XCorneal and Contact Management Optometrist1118AZ
3152WC0802XCorneal and Contact Management Optometrist1146AZ
4152WP0200XPediatric Optometrist1118AZ
5152WP0200XPediatric Optometrist1146AZ
6152W00000XOptometrist1118AZ

General Provider Information

NPI Number : 1275964264
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY EYE ASSOCIATES PLLC
Provider Business Mailing Address
First Line : 12437 N 80TH PL
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-5204
Country : US
Telephone Number : 602-405-2120
Fax Number : 623-551-9120
Provider Business Practice Location Address
First Line : 6145 N 35TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-1940
Country : US
Telephone Number : 602-973-6567
Fax Number : 623-551-9120
Authorized Official
Title or Position : MEMBER/MANAGER/OWNER
Name : DR. THOMAS ROBERT CZYZ
Credential : OD
Telephone Number : 602-405-2120
Provider Enumeration Date : 12/02/2013
Last Update Date : 12/02/2013

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