Provider Demographics
NPI:1639896954
Name:DESERT EYE OPTICAL LLC
Entity Type:Organization
Organization Name:DESERT EYE OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-327-5677
Mailing Address - Street 1:10350 E DREXEL RD STE 230
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-9405
Mailing Address - Country:US
Mailing Address - Phone:520-202-0401
Mailing Address - Fax:520-325-2335
Practice Address - Street 1:10350 E DREXEL RD STE 230
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-9405
Practice Address - Country:US
Practice Address - Phone:520-202-0401
Practice Address - Fax:520-325-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier