Provider Demographics
NPI:1396905170
Name:TOTAL EYECARE CENTER, PC
Entity type:Organization
Organization Name:TOTAL EYECARE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOYLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-345-0090
Mailing Address - Street 1:4015 S MCCLINTOCK DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5877
Mailing Address - Country:US
Mailing Address - Phone:480-345-0090
Mailing Address - Fax:480-345-7094
Practice Address - Street 1:4015 S MCCLINTOCK DR
Practice Address - Street 2:SUITE 107
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5877
Practice Address - Country:US
Practice Address - Phone:480-345-0090
Practice Address - Fax:480-345-7094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-14
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ714152WC0802X, 152WP0200X, 152WS0006X, 152WX0102X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT41743Medicare UPIN
AZ41WCHSQ02Medicare PIN