Provider Demographics
NPI:1134783392
Name:HILDE, STEPHANIE (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:HILDE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:GRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:6993 W SAUCEDA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-1423
Mailing Address - Country:US
Mailing Address - Phone:928-486-7518
Mailing Address - Fax:
Practice Address - Street 1:7041 E TANQUE VERDE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5311
Practice Address - Country:US
Practice Address - Phone:520-298-3028
Practice Address - Fax:520-298-0705
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-002344152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty