Provider Demographics
NPI:1134381775
Name:SHARPER VISION EYECARE, P.C.
Entity type:Organization
Organization Name:SHARPER VISION EYECARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:GIESKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-218-0663
Mailing Address - Street 1:3535 E BROWN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-5602
Mailing Address - Country:US
Mailing Address - Phone:480-218-0663
Mailing Address - Fax:480-324-1494
Practice Address - Street 1:3535 E BROWN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-5602
Practice Address - Country:US
Practice Address - Phone:480-218-0663
Practice Address - Fax:480-324-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ210152W00000X
AZ773152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT76802Medicare UPIN
AZU09398Medicare UPIN