Provider Demographics
NPI:1124204730
Name:BURTON EYECARE ASSOCIATES, P.L.L.C.
Entity Type:Organization
Organization Name:BURTON EYECARE ASSOCIATES, P.L.L.C.
Other - Org Name:HOPE EYE CENTER-PHOENIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:D
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:602-995-2000
Mailing Address - Street 1:1530 W GLENDALE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-8578
Mailing Address - Country:US
Mailing Address - Phone:602-995-2000
Mailing Address - Fax:602-995-8408
Practice Address - Street 1:1530 W GLENDALE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-8578
Practice Address - Country:US
Practice Address - Phone:602-995-2000
Practice Address - Fax:602-995-8408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ119366OtherMEDICARE PTAN