Provider Demographics
NPI:1356746846
Name:ESSENTIAL EYECARE INC.
Entity type:Organization
Organization Name:ESSENTIAL EYECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:623-249-2781
Mailing Address - Street 1:10659 GRAND AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3427
Mailing Address - Country:US
Mailing Address - Phone:623-249-2781
Mailing Address - Fax:623-243-9694
Practice Address - Street 1:10659 GRAND AVE STE 5
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3427
Practice Address - Country:US
Practice Address - Phone:623-249-2781
Practice Address - Fax:623-243-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1554152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty