Provider Demographics
NPI:1639757354
Name:UPPAL OPTOMETRY PLLC
Entity Type:Organization
Organization Name:UPPAL OPTOMETRY PLLC
Other - Org Name:SCOTTSDALE EYEOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:UPPAL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:312-451-1819
Mailing Address - Street 1:23207 N SCOTTSDALE RD STE B105
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4487
Mailing Address - Country:US
Mailing Address - Phone:480-741-8181
Mailing Address - Fax:480-741-8182
Practice Address - Street 1:23207 N SCOTTSDALE RD STE B105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4487
Practice Address - Country:US
Practice Address - Phone:312-451-1819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty