MEDICARE: ADVANCED EYE CARE OF TUCSON, PLLC

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	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician
2	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1851938765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED EYE CARE OF TUCSON, PLLC

Provider Business Mailing Address
First Line	:	5979 E GRANT RD STE 107
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2368
Country	:	US
Telephone Number	:	520-989-1166
Fax Number	:

Provider Business Practice Location Address
First Line	:	5979 E GRANT RD STE 107
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2368
Country	:	US
Telephone Number	:	520-989-1166
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICK TSAI
Credential	:	MD
Telephone Number	:	520-989-1166

Provider Enumeration Date	:	12/10/2019
Last Update Date	:	11/30/2021

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