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General NPI Number Information
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NPI Number | 1144943465
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Entity Type | Organization
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Legal Business Name | GAZE OPTOMETRY LLC
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 2887 S MARKET ST
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City | GILBERT
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State | AZ
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Zip | 85295-1303
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Country | US
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Telephone | 480-366-3963
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Fax | 480-366-3964
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Provider Business Mailing Address
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Address Line | 43722 W BEDFORD DR
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City | MARICOPA
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State | AZ
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Zip | 85138-2329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. NICOLE THOMAS
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Credential | OD
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Telephone | 208-850-7548
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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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