Healthcare Provider Details

I. General information

NPI: 1124204730
Provider Name (Legal Business Name): BURTON EYECARE ASSOCIATES, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 W GLENDALE AVE SUITE 103
PHOENIX AZ
85021-8578
US

IV. Provider business mailing address

1530 W GLENDALE AVE SUITE 103
PHOENIX AZ
85021-8578
US

V. Phone/Fax

Practice location:
  • Phone: 602-995-2000
  • Fax: 602-995-8408
Mailing address:
  • Phone: 602-995-2000
  • Fax: 602-995-8408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAD D BURTON
Title or Position: OWNER
Credential: OD
Phone: 602-995-2000