Provider Demographics
NPI:1023552247
Name:NETRA EYE CLINIC PLLC
Entity Type:Organization
Organization Name:NETRA EYE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THIRIPURASUNDARI
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGAZHENDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-392-0585
Mailing Address - Street 1:5530 N VIA UMBROSA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-6462
Mailing Address - Country:US
Mailing Address - Phone:520-392-0585
Mailing Address - Fax:520-300-4991
Practice Address - Street 1:1241 N WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5154
Practice Address - Country:US
Practice Address - Phone:520-392-0585
Practice Address - Fax:520-300-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46811207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty