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General NPI Number Information
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NPI Number | 1023957842
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Entity Type | Organization
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Legal Business Name | DESERT VALLEY EYE CARE P.L.L.C.
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 1517 S SIGNAL BUTTE RD
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City | MESA
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State | AZ
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Zip | 85209-1630
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Country | US
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Telephone | 971-678-7507
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Fax |
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Provider Business Mailing Address
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Address Line | 607 W DESERT SEASONS DR
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-3431
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Country | US
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Telephone | 971-678-7507
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. BRADLEY BYWATER
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Credential | OD
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Telephone | 971-678-7507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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