Provider Demographics
NPI:1982689667
Name:DESERT EYE ASSOCIATES LTD
Entity Type:Organization
Organization Name:DESERT EYE ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
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 1:1110 N EL DORADO PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4606
Mailing Address - Country:US
Mailing Address - Phone:520-327-5677
Mailing Address - Fax:520-325-2335
Practice Address - Street 1:1150 S CALLE DE LAS CASITAS
Practice Address - Street 2:#150
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-2017
Practice Address - Country:US
Practice Address - Phone:520-625-7450
Practice Address - Fax:520-525-0648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2021-09-21
Deactivation Date:2018-07-12
Deactivation Code:
Reactivation Date:2018-07-31
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZWCHPVMedicare ID - Type Unspecified