Healthcare Provider Details

I. General information

NPI: 1851938765
Provider Name (Legal Business Name): ADVANCED EYE CARE OF TUCSON, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5979 E GRANT RD STE 107
TUCSON AZ
85712-2368
US

IV. Provider business mailing address

5979 E GRANT RD STE 107
TUCSON AZ
85712-2368
US

V. Phone/Fax

Practice location:
  • Phone: 520-989-1166
  • Fax:
Mailing address:
  • Phone: 520-989-1166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICK TSAI
Title or Position: OWNER
Credential: MD
Phone: 520-989-1166