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General NPI Number Information
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NPI Number | 1508272188
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Entity Type | Organization
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Legal Business Name | ONESOURCE SENIOR HEALTHCARE PLLC
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 16427 N SCOTTSDALE RD STE 410
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-7102
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Country | US
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Telephone | 888-495-4489
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Fax | 602-865-8090
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Provider Business Mailing Address
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Address Line | 14050 N 83RD AVE STE 290
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City | PEORIA
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State | AZ
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Zip | 85381-5650
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Country | US
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Telephone | 888-495-4489
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Fax | 602-865-8090
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHDRA SHABA
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Credential | OD
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Telephone | 888-495-4489
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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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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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