MEDICARE: DESERT VALLEY EYE CARE P.L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1023957842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT VALLEY EYE CARE P.L.L.C.

Provider Business Mailing Address
First Line	:	607 W DESERT SEASONS DR
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85143-3431
Country	:	US
Telephone Number	:	971-678-7507
Fax Number	:

Provider Business Practice Location Address
First Line	:	1517 S SIGNAL BUTTE RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85209-1630
Country	:	US
Telephone Number	:	971-678-7507
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. BRADLEY BYWATER
Credential	:	OD
Telephone Number	:	971-678-7507

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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