Healthcare Provider Details

I. General information

NPI: 1629320288
Provider Name (Legal Business Name): PHOENIX EYE CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2012
Last Update Date: 10/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 E BELL RD STE 1800
PHOENIX AZ
85032-2105
US

IV. Provider business mailing address

15639 N 40TH PL
PHOENIX AZ
85032-4101
US

V. Phone/Fax

Practice location:
  • Phone: 602-549-2020
  • Fax:
Mailing address:
  • Phone: 602-370-1414
  • Fax: 602-325-5536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1029
License Number StateAZ

VIII. Authorized Official

Name: DR. SHANNON LYNN STEINHAUSER
Title or Position: OWNER
Credential: OD
Phone: 602-370-1414