Provider Demographics
NPI:1164516522
Name:CORNEA ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:CORNEA ASSOCIATES, PLLC
Other - Org Name:DEAN C. BRICK, MD, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:BRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-325-9400
Mailing Address - Street 1:6422 E SPEEDWAY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1148
Mailing Address - Country:US
Mailing Address - Phone:520-325-9400
Mailing Address - Fax:520-325-8965
Practice Address - Street 1:6422 E SPEEDWAY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1148
Practice Address - Country:US
Practice Address - Phone:520-325-9400
Practice Address - Fax:520-325-8965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ8563Medicare ID - Type Unspecified