Provider Demographics
NPI:1326155896
Name:PACE, THOMAS D (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:D
Last Name:PACE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:8529 W BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-3849
Mailing Address - Country:US
Mailing Address - Phone:623-561-2085
Mailing Address - Fax:
Practice Address - Street 1:18551 N 83RD AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-0501
Practice Address - Country:US
Practice Address - Phone:623-825-9680
Practice Address - Fax:623-825-9878
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ174152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist