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General NPI Number Information
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NPI Number | 1952406787
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Entity Type | Individual
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Provider Name | KATHLEEN VIZE OD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 220 S 63RD ST
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City | MESA
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State | AZ
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Zip | 85206-1619
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Country | US
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Telephone | 480-641-3937
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Fax | 480-786-3956
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Provider Business Mailing Address
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Address Line | PO BOX 200414
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City | DALLAS
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State | TX
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Zip | 75320-0414
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Country | US
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Telephone | 309-846-8955
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Fax | 480-924-5094
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2426
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License Number State | CO
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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 | 002480
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License Number State | AZ
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