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General NPI Number Information
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NPI Number | 1003249798
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Entity Type | Organization
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Legal Business Name | GOODYEAR EYE SPECIALISTS LLC
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Dates
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Enumeration Date | 08/16/2013
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 13657 W MCDOWELL RD STE 209
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City | GOODYEAR
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State | AZ
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Zip | 85395-2603
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Country | US
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Telephone | 623-363-1421
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Fax |
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Provider Business Mailing Address
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Address Line | 13657 W MCDOWELL RD STE 209
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City | GOODYEAR
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State | AZ
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Zip | 85395-2603
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Country | US
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Telephone | 623-363-1421
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HOWARD CHEN
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Credential | MD
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Telephone | 623-363-1421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35744
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License Number State | AZ
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