Provider Demographics
NPI:1912443888
Name:ESTRELLA MOUNTAIN EYE CARE PLLC
Entity Type:Organization
Organization Name:ESTRELLA MOUNTAIN EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PYLE-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:602-790-5990
Mailing Address - Street 1:13065 W MCDOWELL RD
Mailing Address - Street 2:SUITE B105
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-6439
Mailing Address - Country:US
Mailing Address - Phone:623-845-1400
Mailing Address - Fax:623-845-1401
Practice Address - Street 1:13065 W MCDOWELL RD
Practice Address - Street 2:SUITE B105
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6439
Practice Address - Country:US
Practice Address - Phone:623-845-1400
Practice Address - Fax:623-845-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ873152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty