Healthcare Provider Details

I. General information

NPI: 1427886019
Provider Name (Legal Business Name): MY EYE CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 E WARNER RD STE 101
CHANDLER AZ
85225-1058
US

IV. Provider business mailing address

4410 S ROSEMARY PL
CHANDLER AZ
85248-9109
US

V. Phone/Fax

Practice location:
  • Phone: 480-590-0505
  • Fax:
Mailing address:
  • Phone: 212-991-8542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW NORMAN LU
Title or Position: OPTOMETRIST/OWNER
Credential: OD
Phone: 212-991-8542