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General NPI Number Information
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NPI Number | 1952609984
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Entity Type | Organization
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Legal Business Name | DESERT EYE OPTICAL LLC
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 1150 S CALLE DE LAS CASITAS SUITE 120
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-2017
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Country | US
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Telephone | 520-382-2340
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Fax | 520-625-0648
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Provider Business Mailing Address
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Address Line | 1150 S CALLE DE LAS CASITAS SUITE 120
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-2017
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Country | US
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Telephone | 520-327-5677
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Fax | 520-547-2135
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Authorized Official
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Title or Position | ADMIN
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Name | MARIA TURENNE
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Credential |
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Telephone | 520-327-5677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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