Provider Demographics
NPI:1275980633
Name:TOM SOWASH OD & ASSOCIATES, PC
Entity Type:Organization
Organization Name:TOM SOWASH OD & ASSOCIATES, PC
Other - Org Name:VISIONWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-524-6515
Mailing Address - Street 1:PO BOX 849764
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7964
Mailing Address - Country:US
Mailing Address - Phone:210-524-6771
Mailing Address - Fax:
Practice Address - Street 1:21227 S ELLSWORTH LOOP RD
Practice Address - Street 2:STE 102
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-9868
Practice Address - Country:US
Practice Address - Phone:480-987-3097
Practice Address - Fax:480-987-8380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty