Provider Demographics
NPI:1346535978
Name:MIRABIEN, PLLC
Entity Type:Organization
Organization Name:MIRABIEN, PLLC
Other - Org Name:KRISTIN CARTER, MD EYE CARE & SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPHTHALMOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-392-7600
Mailing Address - Street 1:1615 N SWAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4046
Mailing Address - Country:US
Mailing Address - Phone:520-392-7600
Mailing Address - Fax:520-777-7703
Practice Address - Street 1:1615 N SWAN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4046
Practice Address - Country:US
Practice Address - Phone:520-392-7600
Practice Address - Fax:520-777-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-11
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25265207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty