Provider Demographics
NPI:1649049610
Name:MOBILE VISION CONSULTANTS PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:MOBILE VISION CONSULTANTS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FALDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-375-8869
Mailing Address - Street 1:6751 N SUNSET BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3155
Mailing Address - Country:US
Mailing Address - Phone:775-375-8869
Mailing Address - Fax:702-212-9030
Practice Address - Street 1:6751 N SUNSET BLVD STE 320
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-3155
Practice Address - Country:US
Practice Address - Phone:775-375-8869
Practice Address - Fax:702-212-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty