Provider Demographics
NPI:1255707477
Name:TOM SOWASH OD & ASSOCIATES, PC
Entity type:Organization
Organization Name:TOM SOWASH OD & ASSOCIATES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOWASH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-882-8235
Mailing Address - Street 1:PO BOX 849764
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-9764
Mailing Address - Country:US
Mailing Address - Phone:210-524-6771
Mailing Address - Fax:
Practice Address - Street 1:2020 E RIO SALADO PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-3042
Practice Address - Country:US
Practice Address - Phone:480-966-2456
Practice Address - Fax:480-966-0799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty