Provider Demographics
NPI:1659596674
Name:BRIGHT EYES OTICAL
Entity Type:Organization
Organization Name:BRIGHT EYES OTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICAIN
Authorized Official - Phone:480-945-8963
Mailing Address - Street 1:7537 E MCDOWELL RD STE 125
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3536
Mailing Address - Country:US
Mailing Address - Phone:480-945-8963
Mailing Address - Fax:480-990-1938
Practice Address - Street 1:7537 E MCDOWELL RD STE 125
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3536
Practice Address - Country:US
Practice Address - Phone:840-945-8963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty