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General NPI Number Information
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NPI Number | 1265649008
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Entity Type | Organization
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Legal Business Name | DESERT OASIS EYE CARE & OPTICAL
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 09/22/2008
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Provider Practice Location Address
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Address Line | 15256 N 75TH AVE SUITE 380
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City | PEORIA
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State | AZ
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Zip | 85381-4760
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Country | US
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Telephone | 623-412-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 15256 N 75TH AVE SUITE 380
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City | PEORIA
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State | AZ
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Zip | 85381-4760
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Country | US
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Telephone | 623-412-8484
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER J PAROT
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Credential | OD
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Telephone | 623-412-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 848
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 848
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License Number State | AZ
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