Basic Information
| Provider Information | |||||||||
| NPI: | 1013985274 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALLEY EYE SPECIALISTS P L C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 W UNIVERSITY DR | ||||||||
| Address2: | STE 1 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852015833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808330014 | ||||||||
| FaxNumber: | 4808356821 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 W UNIVERSITY DR | ||||||||
| Address2: | STE 1 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852015833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808330014 | ||||||||
| FaxNumber: | 4808356821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 11/12/2015 | ||||||||
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| AuthorizedOfficialLastName: | MORETSKY | ||||||||
| AuthorizedOfficialFirstName: | SANFORD | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 4808330014 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.