Provider Demographics
NPI:1497930143
Name:LEVEEN FAMILY EYECARE
Entity Type:Organization
Organization Name:LEVEEN FAMILY EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TORRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:602-237-3330
Mailing Address - Street 1:6170 S 51ST AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-6304
Mailing Address - Country:US
Mailing Address - Phone:602-237-3330
Mailing Address - Fax:
Practice Address - Street 1:6170 S 51ST AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-6304
Practice Address - Country:US
Practice Address - Phone:602-237-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1205152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty