Provider Demographics
NPI:1629320288
Name:PHOENIX EYE CARE PLLC
Entity Type:Organization
Organization Name:PHOENIX EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:STEINHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:602-370-1414
Mailing Address - Street 1:15639 N 40TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4101
Mailing Address - Country:US
Mailing Address - Phone:602-370-1414
Mailing Address - Fax:602-325-5536
Practice Address - Street 1:3805 E BELL RD
Practice Address - Street 2:STE 1800
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2105
Practice Address - Country:US
Practice Address - Phone:602-549-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-07
Last Update Date:2012-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1029152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty